Triglyceride-glucose index and preeclampsia risk: A systematic review and meta-analysis

Insulin resistance plays a role in preeclampsia (PE), yet the clinical utility of the triglyceride-glucose (TyG) index is unclear. This systematic review and meta-analysis evaluated the association between the TyG index and PE, as well as its diagnostic accuracy. We searched eight databases for observational studies published from inception to December 31, 2025. Data were synthesized using random-effects models, with subgroup and sensitivity analyses addressing heterogeneity. Our analysis included 12 studies involving 103,702 pregnant women. A higher TyG index was linked to increased odds of PE, with a pooled odds ratio of 1.85 (95% CI: 1.48-2.32). Significant heterogeneity was observed across studies (I² = 71.2%). In five studies, the pooled sensitivity was 0.65 (95% CI: 0.49-0.78), specificity was 0.58 (95% CI: 0.50-0.65), and the area under the summary receiver operating characteristic curve was 0.64 (95% CI: 0.59-0.68), suggesting limited discriminatory power. Limitations included substantial heterogeneity, a predominance of Chinese populations, and TyG measurements taken near or after PE onset in some studies. While the TyG index is an exploratory metabolic marker associated with PE, these findings do not confirm its prospective predictive value or support its use as a standalone screening tool. Its incremental contribution to multivariable prediction models requires prospective validation in diverse populations, using standardized measurement timing and predefined thresholds.