Abstract
BACKGROUND: Colorectal cancer (CRC) is one of the most common malignancies worldwide, with increasing evidence linking metabolic dysregulation, such as insulin resistance and chronic inflammation, to its development and progression. A potential useful predictor of CRC risk is the triglyceride-glucose (TyG) index, a marker for insulin resistance that is determined using fasting triglyceride and glucose levels. The purpose of this systematic review was to assess the relationship between the TyG index and CRC and ascertain whether the TyG index is associated with the development and outcomes of CRC. METHODS: A systematic review and meta-analysis was reported in accordance with the PRISMA guidelines. Comprehensive searches of PubMed, Web of Science, Scopus, and World Health Organization Virtual Health Library were conducted in 24th March 2025 to find studies assessing the relationship between the TyG index and CRC. Results of association between TyG index and CRC were summarized and a meta-analysis was done to calculate pooled hazard ratio (HR) with 95% confidence interval (CI). RESULTS: A total of eight studies were included in the systematic review, of which five met the criteria for inclusion in the quantitative synthesis. The pooled analysis showed that the hazard of developing CRC was significantly greater for those with a higher TyG index (HR = 1.18; 95% CI: 1.12-1.25; P <.001). In addition, meta-analysis indicated that hazard of developing CRC significantly increased for each one-unit increase in the TyG index (HR = 1.28, 95% CI: 1.18 to 1.39, P <.001). CONCLUSION: Higher TyG index level is substantially linked to an elevated hazard of developing CRC. Therefore, the TyG index can be a useful tool for CRC risk identification. Standardizing cut-off values and researching clinical applicability in various populations should be the main goals of future research. Due to the limitations posed by the small number of studies, further prospective studies are needed to generate more robust and generalizable evidence.