TyG-BMI Index Predicts Colorectal Cancer Risk, Study Finds

Elevated triglyceride-glucose (TyG) index and TyG–body mass index (TyG-BMI) levels may be associated with a greater likelihood of developing colorectal cancer (CRC), a new study suggests.1 However, researchers found no clear connection between these markers and CRC-related mortality, indicating their potential use in cancer risk assessment but not prognosis.

TyG-BMI displayed significant associations with the incidence of CRC | Image credit: M+Isolation+Photo - stock.adobe.com

This meta-analysis study is published in Lipids in Health and Disease.

“The analyses uncovered that while the TyG index was nonlinearly connected to CRC incidence, TyG-BMI exhibited a positive linear trend with CRC risk,” wrote the researchers of the study. “Notably, TyG-BMI demonstrated predictive superiority compared with the TyG index. Furthermore, subgroup analysis revealed that sex, especially women, and TyG-BMI displayed significant associations with the likelihood of CRC.”

A previous historical cohort study involving nearly 28,000 participants found that a higher TyG index was significantly associated with an increased risk of CRC.2 Over a median 4.4-year follow-up, individuals with elevated TyG levels had a 1.38-fold higher risk of developing CRC after adjusting for multiple lifestyle and clinical factors. The study also identified a TyG index cut-off of 8.272 for predicting CRC incidence, highlighting the index’s potential role in early CRC screening strategies.

In the current study, the researchers utilized data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) to investigate associations between the TyG index, TyG-related indices, and CRC risk and mortality.1 The meta-analysis included studies published up to April 1, 2025, that reported TyG values in relation to CRC incidence. Subgroup analyses were also performed to identify populations with elevated CRC risk.

Multivariate logistic regression analysis revealed a significantly higher incidence of CRC among individuals in the second, third, and fourth quartiles of both the TyG index and TyG-BMI, with progressively increasing ORs across quartiles (P < 0.001). Specifically, the CIs for TyG ranged from 1.14 to 2.12 and for TyG-BMI from 1.07 to 1.93.

However, the researchers identified a significant increase in CRC-related mortality only in the second TyG quartile (95% CI, 1.22-7.47; P < .05), with no clear dose-response pattern in higher quartiles. Furthermore, a nonlinear association was identified between TyG and CRC incidence (P = .045), whereas TyG-BMI exhibited a linear trend (P = .385 for nonlinearity). The analysis confirmed TyG-BMI as the strongest predictor of CRC risk, yielding an area under the curve of 0.71.

Subgroup analysis highlighted a statistically significant link between CRC incidence and both TyG-BMI and female sex, suggesting potential sex-specific metabolic risk factors.

The researchers noted several limitations to the study. First, unmeasured confounding may have influenced the findings, and the retrospective design limited causal interpretation. Additionally, results based on NHANES data may not be generalizable globally, and self-reported information could have introduced misclassification bias. Lastly, using all-cause mortality may have underestimated the true link between TyG indices and CRC-specific outcomes.

Despite these limitations, the researchers believe the study suggests that TyG-BMI displayed significant associations with the incidence of CRC, while TyG and associated indices showed no significant interrelationships with the mortality of CRC.

“TyG-BMI outperformed all the other indicators considered in this study, and it can help preemptively identify people with a higher likelihood of developing CRC, implement personalized intervention measures, and assist doctors in determining which populations would need to undergo colonoscopy screening,” wrote the researchers. “This may help avoid unnecessary examinations and reducing economic, physical, and psychological burdens.”

References

1. Luo L, Liu Z, Gan Q, et al. Relationships of triglyceride-glucose-related indices with colorectal cancer incidence and mortality in an American population: a dose-response meta-analysis and cohort study. Lipids Health Dis. 2025;24(1):151. doi: 10.1186/s12944-025-02574-x

2. Okamura T, Hashimoto Y, Hamaguchi M, et al. Triglyceride-glucose index (TyG index) is a predictor of incident colorectal cancer: a population-based longitudinal study. BMC Endocr Disord. 2020;20(1):113. doi:10.1186/s12902-020-00581-w