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Volume 41 Issue 7
Jul.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(7): 1407-1413

Association between triglyceride-glucose index and gallstones in women： A cross-sectional study

DOI: 10.12449/JCH250727
  • 1.

    Department of Gastroenterology, Subei People’s Hospital Affiliated to Yangzhou University，Yangzhou，Jiangsu 225001，China

  • 2.

    Department of Cardiology, Subei People’s Hospital Affiliated to Yangzhou University，Yangzhou，Jiangsu 225001，China

  • 3.

    Department of Hepatobiliary Surgery, Subei People’s Hospital Affiliated to Yangzhou University，Yangzhou，Jiangsu 225001，China

  • 4.

    Department of Gastrointestinal Surgery, Subei People’s Hospital Affiliated to Yangzhou University，Yangzhou，Jiangsu 225001，China

Research funding:

Jiangsu Basic Research Program （Natural Science Foundation） Youth Fund Project (BK20240489);

Jiangsu Traditional Chinese Medicine Science and Technology Development Plan General Project (MS2023138)

More Information
  • Corresponding author: ZHU Ying， bujingzhuying@126.com （ORCID： 0000-0001-9880-5330）
  • Received Date: 2024-12-27
  • Accepted Date: 2025-01-14
  • Published Date: 2025-07-25
    Abstract
  •   Objective  To investigate the association between triglyceride-glucose （TyG） index and the prevalence of gallstones in women， and to assess whether it can be used as a convenient indicator for the epidemiological survey of gallstones in women.  Methods  A total of 22 979 adult women who underwent physical examination in Subei People’s Hospital of Jiangsu from January 2021 to June 2023 were enrolled， and according to the results of abdominal color Doppler ultrasound， they were divided into gallstone group with 1 763 women and non-gallstone group with 21 216 women. The independent samples t-test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups； the chi-square test was used for comparison of categorical data between groups. The multivariate logistic regression analysis， the restricted cubic spline analysis， the subgroup analysis， and mediating effect were used to investigate the association between TyG index and the risk of gallstones in women.  Results  The overall prevalence rate of gallstones was 7.7% in women. Compared with the non-gallstone group， the gallstone group had significantly higher age， BMI， FPG， TG， TyG index， TC， Hb， BUN， UA， SCr， TC， and LDL-C （all P<0.05）， and the women with diabetes， fatty liver， hypertension， and hyperuricemia were more likely to have gallstones （all P<0.05）. The multivariate logistic regression analysis showed that based on the quartiles of TyG index， the risk of gallstones in the Q3 （8.97‍ ‍—‍ ‍9.38） group was 1.38 （95% confidence interval ［CI］： 1.15‍ ‍—‍ ‍1.62， P<0.001） times that in the Q1 （<8.63） group， and the risk of gallstones in the Q4 （≥9.38） group was 1.39 （95%CI： 1.16‍ ‍—‍ ‍1.68， P<0.001） times that in the Q1 group. After adjustment for all covariates， TyG index， as a continuous variable， showed an independent positive correlation with the risk of gallstones （odds ratio ［OR］=1.24， 95%CI： 1.11‍ ‍—‍ ‍1.39， P=0.004）. The restricted cubic spline curve revealed a significant nonlinear association between TyG index and the risk of gallstones （P for non linear=0.008）， and the threshold analysis showed statistical significance in the effect of TyG index below the inflection point of 8.95 （OR=1.34， 95%CI： 1.15‍ ‍—‍ ‍1.97， P=0.042）. The subgroup analysis showed that TyG index was significantly positively correlated with gallstones in women with a BMI of<25 kg/m²， an age of<50 years， an age of ≥50 years， the absence of diabetes or fatty liver， total cholesterol<5.72 mmol/L， total bilirubin<21 μmol/L， a hemoglobin level of 110‍ ‍—‍ ‍150 g/L， and blood urea nitrogen<7.5 μmol/L （all P<0.05）. A mediating analysis was performed for the subgroups with a statistically significant P value for interaction， and the results showed that BMI accounted for 23.0% of the mediating effect in the influence of TyG index on gallstones， and fatty liver and diabetes accounted for 15.7% and 21.0%， respectively.  Conclusion  In women， a higher TyG index indicates a higher risk of gallstones. Lowering TyG index may reduce the risk of gallstones by improving insulin sensitivity.

     

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    • References(32)
  • [1]
    WANG X, YU WQ, JIANG GH, et al. Global epidemiology of gallstones in the 21st century: A systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2024, 22( 8): 1586- 1595. DOI: 10.1016/j.cgh.2024.01.051.
    [2]
    LAMMERT F, GURUSAMY K, KO CW, et al. Gallstones[J]. Nat Rev Dis Primers, 2016, 2: 16024. DOI: 10.1038/nrdp.2016.24.
    [3]
    SIMONSEN MH, ERICHSEN R, FRØSLEV T, et al. Postmenopausal estrogen therapy and risk of gallstone disease: A population-based case-control study[J]. Drug Saf, 2013, 36( 12): 1189- 1197. DOI: 10.1007/s40264-013-0118-7.
    [4]
    SUN XH, WANG YJ, ZHANG W, et al. Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: A report of 6 159 cases[J]. Chin J Dig Surg, 2022, 21( 1): 114- 128. DOI: 10.3760/cma.j.cn115610-20220103-00004.

    孙旭恒, 王一钧, 张薇, 等. 中国胆囊癌流行病学特征与诊治及预后分析(附6 159例报告)[J]. 中华消化外科杂志, 2022, 21( 1): 114- 128. DOI: 10.3760/cma.j.cn115610-20220103-00004.
    [5]
    ZHU Q, XING YW, FU YF, et al. Causal association between metabolic syndrome and cholelithiasis: A Mendelian randomization study[J]. Front Endocrinol(Lausanne), 2023, 14: 1180903. DOI: 10.3389/fendo.2023.1180903.
    [6]
    SUN YT, JI HY, SUN WJ, et al. Triglyceride glucose(TyG) index: A promising biomarker for diagnosis and treatment of different diseases[J]. Eur J Intern Med, 2025, 131: 3- 14. DOI: 10.1016/j.ejim.2024.08.026.
    [7]
    LUO PP, LIU Q, HUANG LW. Predictive value of triglyceride-glucose body mass index(TyG-BMI) for the severity of hyperlipidemic acute pancreatitis[J]. J Clin Hepatol, 2024, 40( 8): 1661- 1665. DOI: 10.12449/JCH240824.

    罗萍萍, 刘群, 黄丽雯. 甘油三酯葡萄糖体质量指数(TyG-BMI)对高脂血症性急性胰腺炎严重程度的预测价值[J]. 临床肝胆病杂志, 2024, 40( 8): 1661- 1665. DOI: 10.12449/JCH240824.
    [8]
    LYU JT, LIN QH, FANG ZB, et al. Complex impacts of gallstone disease on metabolic syndrome and nonalcoholic fatty liver disease[J]. Front Endocrinol(Lausanne), 2022, 13: 1032557. DOI: 10.3389/fendo.2022.1032557.
    [9]
    CAMPOREZ JP, LYU K, GOLDBERG EL, et al. Anti-inflammatory effects of oestrogen mediate the sexual dimorphic response to lipid-induced insulin resistance[J]. J Physiol, 2019, 597( 15): 3885- 3903. DOI: 10.1113/JP277270.
    [10]
    STUBBINS RE, NAJJAR K, HOLCOMB VB, et al. Oestrogen alters adipocyte biology and protects female mice from adipocyte inflammation and insulin resistance[J]. Diabetes Obes Metab, 2012, 14( 1): 58- 66. DOI: 10.1111/j.1463-1326.2011.01488.x.
    [11]
    TAHAPARY DL, PRATISTHITA LB, FITRI NA, et al. Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and Tryglyceride/glucose index[J]. Diabetes Metab Syndr, 2022, 16( 8): 102581. DOI: 10.1016/j.dsx.2022.102581.
    [12]
    The Editorial Board of“Clinical Guide for the Prevention and Treatment of Geriatric Diabetes in China”. Clinical guide for the prevention and treatment of type 2 diabetes in elderly Chinese(2022 Edition)[J]. Chin J Diabetes, 2022, 30( 1): 2- 51. DOI: 10.3969/j.issn.1006-6187.2022.01.002.

    《中国老年型糖尿病防治临床指南》编写组. 中国老年2型糖尿病防治临床指南(2022年版)[J]. 中国糖尿病杂志, 2022, 30( 1): 2- 51. DOI: 10.3969/j.issn.1006-6187.2022.01.002.
    [13]
    Chinese Medical Doctor Association, Branch Nephrology. Practice guidelines for the diagnosis and treatment of hyperuricemia in kidney disease in China(2017 Edition)[J]. Nat Med J China, 2017, 97( 25): 1927- 1936. DOI: 10.3760/cma.j.issn.0376-2491.2017.25.003.

    中国医师协会肾脏内科医师分会. 中国肾脏疾病高尿酸血症诊治的实践指南(2017版)[J]. 中华医学杂志, 2017, 97( 25): 1927- 1936. DOI: 10.3760/cma.j.issn.0376-2491.2017.25.003.
    [14]
    Editorial Board of Chinese Journal of Digestion, Hepatobiliary Disease Cooperation Group of Chinese Society of Gastroenterology. Consensus on diagnosis and treatment of chronic cholecystitis and gallstones in China(2018)[J]. J Clin Hepatol, 2019, 35( 6): 1231- 1236. DOI: 10.3969/j.issn.1001-5256.2019.06.11.

    中华消化杂志编辑委员会, 中华医学会消化病学分会肝胆疾病协作组. 中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2018年)[J]. 临床肝胆病杂志, 2019, 35( 6): 1231- 1236. DOI: 10.3969/j.issn.1001-5256.2019.06.11.
    [15]
    Chinese Society of Hepatology. Guidelines for the prevention and treatment of metabolic dysfunction-associated(Non-Alcoholic) fatty liver disease(2024 Edition)[J]. J Prac Hepatol, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.

    中华医学会肝病学分会. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 实用肝脏病杂志, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.
    [16]
    LI CY, ZHU P, JIAO P, et al. Association between triglyceride-glucose index and the risk of gallstone disease: A multicenter health check-up population study[J]. Modern Prevent Med, 2023, 50( 5): 775- 780, 802. DOI: 10.20043/j.cnki.MPM.202211404.

    李春燕, 朱培, 焦鹏, 等. 甘油三酯-葡萄糖指数与胆石病患病风险关联——多中心健康体检人群研究[J]. 现代预防医学, 2023, 50( 5): 775- 780, 802. DOI: 10.20043/j.cnki.MPM.202211404.
    [17]
    GONG L, FAN SJ, PENG ZF, et al. The association between triglyceride-glucose index and gallstones: NHANES 2017-2020[J]. Front Endocrinol(Lausanne), 2024, 15: 1437711. DOI: 10.3389/fendo.2024.1437711.
    [18]
    LI HL, ZHANG CF. Association between triglyceride-glucose index and gallstones: A cross-sectional study[J]. Sci Rep, 2024, 14( 1): 17778. DOI: 10.1038/s41598-024-68841-6.
    [19]
    FENG XY, WU SW, KE B, et al. Elevated TyG index associated with increased prevalence of gallstones in a United States cross-sectional study[J]. Front Public Health, 2024, 12: 1351884. DOI: 10.3389/fpubh.2024.1351884.
    [20]
    Branch of Biliary Surgery Chinese Surgical Society, Chinese Committee of Biliary Surgeons. Guideline for the diagnosis and treatment of gallbladder carcinoma(2019 edition)[J]. Chin J Surg, 2020, 58( 4): 243- 251. DOI: 10.3760/cma.j.cn112139-20200106-00014.

    中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科专业委员会. 胆囊癌诊断和治疗指南(2019版)[J]. 中华外科杂志, 2020, 58( 4): 243- 251. DOI: 10.3760/cma.j.cn112139-20200106-00014.
    [21]
    BIDDINGER SB, HAAS JT, YU BB, et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones[J]. Nat Med, 2008, 14( 7): 778- 782. DOI: 10.1038/nm1785.
    [22]
    ZHU Q, SUN XB, JI XK, et al. The association between gallstones and metabolic syndrome in urban Han Chinese: A longitudinal cohort study[J]. Sci Rep, 2016, 6: 29937. DOI: 10.1038/srep29937.
    [23]
    CAZZO E, GESTIC MA, UTRINI MP, et al. Influence of insulin resistance status on the development of gallstones following roux-en-Y gastric bypass: A prospective cohort study[J]. Obes Surg, 2016, 26( 4): 769- 775. DOI: 10.1007/s11695-015-1815-3.
    [24]
    NERVI F, MIQUEL JF, ALVAREZ M, et al. Gallbladder disease is associated with insulin resistance in a high risk Hispanic population[J]. J Hepatol, 2006, 45( 2): 299- 305. DOI: 10.1016/j.jhep.2006.01.026.
    [25]
    HYOGO H, ROY S, PAIGEN B, et al. Leptin promotes biliary cholesterol elimination during weight loss in ob/ob mice by regulating the enterohepatic circulation of bile salts[J]. J Biol Chem, 2002, 277( 37): 34117- 34124. DOI: 10.1074/jbc.M203912200.
    [26]
    WEN J, JIANG Y, LEI ZM, et al. Leptin influence cholelithiasis formation by regulating bile acid metabolism[J]. Turk J Gastroenterol, 2021, 32( 1): 97- 105. DOI: 10.5152/tjg.2020.19594.
    [27]
    TAKEUCHI T, KUBOTA T, NAKANISHI Y, et al. Gut microbial carbohydrate metabolism contributes to insulin resistance[J]. Nature, 2023, 621( 7978): 389- 395. DOI: 10.1038/s41586-023-06466-x.
    [28]
    WANG QH, JIAO L, HE CQ, et al. Alteration of gut microbiota in association with cholesterol gallstone formation in mice[J]. BMC Gastroenterol, 2017, 17( 1): 74. DOI: 10.1186/s12876-017-0629-2.
    [29]
    LAVOIE JM. Dynamics of hepatic and intestinal cholesterol and bile acid pathways: The impact of the animal model of estrogen deficiency and exercise training[J]. World J Hepatol, 2016, 8( 23): 961- 975. DOI: 10.4254/wjh.v8.i23.961.
    [30]
    DE PAOLI M, ZAKHARIA A, WERSTUCK GH. The role of estrogen in insulin resistance: A review of clinical and preclinical data[J]. Am J Pathol, 2021, 191( 9): 1490- 1498. DOI: 10.1016/j.ajpath.2021.05.011.
    [31]
    YANG SJ, YU B, YU WQ, et al. Development and validation of an age-sex-ethnicity-specific metabolic syndrome score in the Chinese adults[J]. Nat Commun, 2023, 14( 1): 6988. DOI: 10.1038/s41467-023-42423-y.
    [32]
    FAHED G, AOUN L, ZERDAN M BOU, et al. Metabolic syndrome: Updates on pathophysiology and management in 2021[J]. Int J Mol Sci, 2022, 23( 2): 786. DOI: 10.3390/ijms23020786.
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