Association between TyG-related indices and colorectal cancer risk: A prospective cohort study

Insulin resistance is an important risk factor for the development of colorectal cancer (CRC), and triglyceride-glucose (TyG) related indices, as emerging biomarkers of insulin resistance, have not been thoroughly studied in the context of CRC risk assessment. This study aimed to evaluate the relationships between three TyG-related indices-specifically triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference index (TyG-WC), and triglyceride glucose-waist to height ratio index (TyG-WHtR)-and CRC risk within a large prospective cohort from the Kailuan Study (2006-2019), which included 173,342 cancer-free participants. During a median follow-up of 14.23 years, 977 incident CRC cases were identified. Multivariable Cox proportional hazards models revealed significant positive associations between the TyG-related indices and CRC risk: for TyG-BMI, those in the third and fourth quartiles had hazard ratios (HRs) of 1.22 (95% CI: 1.01-1.48) and 1.35 (95% CI: 1.11-1.64), respectively; for TyG-WC, the fourth quartile had an HR of 1.43 (95% CI: 1.17-1.74); and for TyG-WHtR, the third and fourth quartiles had HRs of 1.28 (95% CI: 1.05-1.57) and 1.37 (95% CI: 1.12-1.68), respectively. Dose-response analyses demonstrated linear relationships for all indices (all p for overall = 0.001, p for non-linear >0.05). The results show a significant association between elevated TyG indices and increased colorectal cancer (CRC) risk, suggesting that these markers may have potential value in risk stratification.