Background
The triglyceride-glucose index (TyG) and its associated obesity indicators [TyG-body mass index(TyG-BMI), TyG-waist-height ratio(TyG-WHtR), and TyG-waist circumference(TyG-WC)] are emerging tools for assessing insulin resistance. This study aimed to examine the association between TyG obesity-related indicators and the risk of gallstone disease or first gallbladder surgery.
Methods
Individuals were selected from the 2017–2020 National Health and Nutrition Examination Survey (NHANES) database. The associations between TyG, TyG-WHtR, TyG-WC, TyG-BMI, and the risk of gallstone disease and first gallbladder surgery were initially analyzed using weighted logistic regression models. Restricted cubic spline (RCS) plots and receiver operating characteristic (ROC) curves were used to analyze the relationship between TyG obesity-related indicators and gallstone disease and first gallbladder surgery. Generalized additive models, smoothed curve fitting, and linear regression were applied to assess the relationship between TyG-WC and age at first gallbladder surgery. Sensitivity analyses, including stratified and interaction analyses, were conducted to identify specific populations and assess potential interactions between covariates and TyG obesity-related indicators. Mediation analyses explored the role of ethnicity as a mediator between TyG-WHtR and first gallbladder surgery.
Results
In this study, TyG obesity-related indicators were significantly correlated with the risk of gallstone disease and first gallbladder surgery, except for TyG, which showed no significant correlation. A linear relationship was observed between TyG obesity-related indicators and the risk of gallstone disease (P-overall < 0.0001, P-nonlinear > 0.05). In addition, TyG-WC demonstrated the strongest performance in predicting the risk of first gallbladder surgery and was negatively associated with age at first gallbladder surgery (β = -0.03, 95% CI: -0.04, -0.01). Sensitivity analysis indicated that TyG-WHtR was more strongly correlated with first gallbladder surgery in other races (OR = 3.13, 95% CI: 1.67, 5.86). Mediation analyses showed that race mediated the association between TyG-WHtR and first gallbladder surgery.
CONCLUSION
TyG-WHtR, TyG- WC, and TyG-BMI were correlated and linearly associated with gallstones and first gallbladder surgery. In addition TyG- WC showed the most favourable performance in predicting the risk of first gallbladder surgery and may lead to an earlier age of first gallbladder surgery. In addition attention needs to be paid to the effect of other races between TyG-WHtR and first gallstone surgery.