Higher TyG Index Linked to Increased Kidney Stone Risk: Study

To establish the epidemiological association between insulin resistance and kidney stones, the authors conducted a highly meticulous systematic review and meta-analysis based on the PRISMA 2020 criteria and following a well-defined, PROSPERO-registered protocol. Specifically, the authors thoroughly searched the major international databases such as PubMed, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest for relevant studies up to May 22, 2026. This study focused only on the observational designs that examined the association between adults and the TyG index as a mathematical calculation of the product of fasting triglycerides and glucose, which can be considered as a continuous and/or categorical variable, in relation to the development of kidney stones.

The JBI tools were used to assess the quality of each trial independently. For synthesizing the ORs from the selected trials for a pooled analysis, the authors used REML random-effects methods. In addition, one-stage dose-response meta-analyses by linear and RCS models were also conducted to determine the trend of the risk, and GRADE was applied to evaluate the certainty of the evidence.

Key findings:

• The systematic review successfully analyzed information from 14 eligible observational studies involving a total population of 1,066,215 adult subjects.
• With a total sample population size of over 1.06 million people, the research was able to confirm 50,286 recorded instances of kidney stones.
• The results from the continuous meta-analysis indicated that a change in value of 1 unit in patients' base TyG index was associated with 33% increased odds of developing kidney stones with a pooled adjusted odds ratio of 1.33 (95% CI: 1.15–1.54).
• Among the extremes on the two metabolic categories, subjects belonging to the highest TyG index category had a probability 52% higher than those belonging to the lowest index (OR: 1.52; 95% CI: 1.26–1.84).
• In the one-stage random-effects dose-response model used in the meta-analysis, while the restricted cubic spline was noted to be a better fit for mathematical purposes, no evidence of non-linear effects was found.
• Based on a linear association, for each 1-unit increase in a participant's base TyG index, odds of having kidney stones increased by 26% (OR: 1.26; 95% CI: 1.12–1.42; 95% prediction interval: 0.91–1.75).

The results showed that increased levels of TyG index were related to KSD development in a generally linear fashion, but considering the high heterogeneity observed among included studies, one must regard TyG index more as a possible risk factor indicator, as opposed to screening tool. These results can be useful for overall cardiometabolic risks evaluation and preventive counseling among patients vulnerable to developing KSD. In addition, conducting this worldwide meta-analysis was absolutely necessary from a scientific point of view since it revealed the close connection between systemic insulin resistance and metabolism.

Reference:

Maleki, S., Darouei, B., Amin, A. et al. Association between the triglyceride-glucose index and kidney stone disease: a systematic review and dose-response meta-analysis. Lipids Health Dis (2026). https://doi.org/10.1186/s12944-026-02994-3