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Meta-Analysis
. 2023 Nov 22:14:1282675.
doi: 10.3389/fendo.2023.1282675. eCollection 2023.

Diagnostic efficacy of the triglyceride-glucose index in the prediction of contrast-induced nephropathy following percutaneous coronary intervention

Wei Ting Chang  1   2   3 , Chien-Cheng Liu  4   5   6 , Yen-Ta Huang  7 , Jheng-Yan Wu  8 , Wen-Wen Tsai  9 , Kuo Chuan Hung  10   11 , I Wen Chen #  12 , Ping-Hsun Feng #  12
Affiliations
Meta-Analysis

Diagnostic efficacy of the triglyceride-glucose index in the prediction of contrast-induced nephropathy following percutaneous coronary intervention

Wei Ting Chang et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Contrast-induced nephropathy (CIN) is a common complication of percutaneous coronary intervention (PCI). Identifying patients at high CIN risk remains challenging. The triglyceride-glucose (TyG) index may help predict CIN but evidence is limited. We conducted a meta-analysis to evaluate the diagnostic value of TyG index for CIN after PCI.

Methods: A systematic literature search was performed in MEDLINE, Cochrane, and EMBASE until August 2023 (PROSPERO registration: CRD42023452257). Observational studies examining TyG index for predicting CIN risk in PCI patients were included. This diagnostic meta-analysis aimed to evaluate the accuracy of the TyG index in predicting the likelihood of CIN. Secondary outcomes aimed to assess the pooled incidence of CIN and the association between an elevated TyG index and the risk of CIN.

Results: Five studies (Turkey, n=2; China, n=3) with 3518 patients (age range: 57.6 to 68.22 years) were included. The pooled incidence of CIN was 15.3% [95% confidence interval (CI) 11-20.8%]. A high TyG index associated with increased CIN risk (odds ratio: 2.25, 95% CI 1.82-2.77). Pooled sensitivity and specificity were 0.77 (95% CI 0.59-0.88) and 0.55 (95% CI 0.43-0.68) respectively. Analysis of the summary receiver operating characteristic (sROC) curve revealed an area under the curve of 0.69 (95% CI 0.65-0.73). There was a low risk of publication bias (p = 0.81).

Conclusion: The TyG index displayed a noteworthy correlation with the risk of CIN subsequent to PCI. However, its overall diagnostic accuracy was found to be moderate in nature. While promising, the TyG index should not be used in isolation for CIN screening given the heterogeneity between studies. In addition, the findings cannot be considered conclusive given the scarcity of data. Further large-scale studies are warranted to validate TyG cutoffs and determine how to optimally incorporate it into current risk prediction models.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023452257, identifier CRD42023452257.

Keywords: cardiovascular disease; contrast-induced nephropathy; insulin resistance; meta-analysis; triglyceride-glucose index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for study selection.
Figure 2
Figure 2
Methodological quality summary of included studies.
Figure 3
Figure 3
Pooled incidence of contrast-induced nephropathy (CIN).
Figure 4
Figure 4
Forest plot showing a positive relationship between a high triglyceride–glucose (TyG) index and the risk of contrast-induced nephropathy.
Figure 5
Figure 5
Forest plot depicting the combined sensitivity and specificity of the triglyceride–glucose (TyG) index in predicting contrast-induced nephropathy.
Figure 6
Figure 6
Analysis on summary receiver operating characteristic (sROC) curve demonstrating the predictive effectiveness of the triglyceride–glucose Index concerning contrast-induced nephropathy.
Figure 7
Figure 7
The clinical applicability of the triglyceride–glucose (TyG) index in forecasting the occurrence of contrast-induced nephropathy illustrated through Fagan’s nomogram plot.
Figure 8
Figure 8
Utilizing Deek’s funnel plot asymmetry test, the probability of publication bias was deemed minimal (p = 0.81).
See this image and copyright information in PMC

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Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by Chi Mei Medical Center, Tainan, Taiwan, grant number CMOR11203. This work was supported by Chi Mei Medical Center, Liouying branch.