Association between triglyceride-glucose index and risk of chronic kidney disease: a meta-analysis

The triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, has been increasingly investigated for its predictive value in chronic kidney disease (CKD). However, many existing studies are cross-sectional, and the longitudinal evidence remains inconclusive. This meta-analysis aimed to evaluate the association between baseline TyG index and the incidence of CKD in adults. A systematic search of PubMed, Embase, and Web of Science was conducted through March 2025. Longitudinal cohort studies assessing the relationship between TyG index and CKD risk in adults were included. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Thirteen datasets from 12 cohort studies (n = 58,838) were included. A high TyG index at baseline was associated with a significantly increased risk of CKD during follow-up (RR: 1.44, 95% CI: 1.33-1.56) with mild heterogeneity (I² = 7%). This association remained robust in sensitivity analyses and in prospective studies alone (RR: 1.55, 95% CI: 1.37-1.75). Subgroup analyses showed consistent associations across different populations, age groups, BMI categories, and TyG cutoff definitions. Notably, a stronger association was observed in studies with follow-up durations < 4 years compared to those with longer follow-up (RR: 1.61 vs. 1.29; p for subgroup difference = 0.004), suggesting that the predictive value of TyG index is more evident in shorter-term risk assessment. In conclusions, elevated TyG index is independently associated with an increased risk of incident CKD in adults, particularly within shorter follow-up durations, highlighting its potential utility in early risk stratification.