Background: The triglyceride-glucose (TyG) index is a new alternative measure for insulin resistance. This meta-analysis was conducted to assess the associations of the TyG index with the risks of cardiovascular diseases and mortality in the general population. Methods: The PubMed, Cochrane Library and Embase databases were searched for randomized controlled trials or observational cohort studies reporting associations of the TyG index with cardiovascular diseases and mortality from inception to April 16, 2022. Effect sizes were pooled using random-effects models. Robust error meta-regression methods were applied to fit nonlinear dose–response associations. Evidence quality levels and recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation system (GRADE). Results: Twelve cohort studies (6 prospective and 6 retrospective cohorts) involving 6,354,990 participants were included in this meta-analysis. Compared with the lowest TyG index category, the highest TyG index was related to a higher incidence of coronary artery disease (CAD) (3 studies; hazard ratio [HR] = 2.01; 95% confidence interval [CI] 1.68–2.40; I² = 0%), myocardial infarction (MI) (2 studies; HR = 1.36; 95% CI 1.18–1.56; I² = 35%), and composite cardiovascular disease (CVD) (5 studies; HR = 1.46; 95% CI 1.23–1.74; I² = 82%). However, there was no association between the TyG index and mortality (cardiovascular mortality [3 studies; HR = 1.10; 95% CI 0.82–1.47; I² = 76%] or all-cause mortality [4 studies; HR = 1.08; 95% CI 0.92–1.27; I² = 87%]). In the dose–response analysis, there was a linear association of the TyG index with the risk of CAD (P_nonlinear = 0.3807) or CVD (P_nonlinear = 0.0612). GRADE assessment indicated very low certainty for CVD, MI, cardiovascular mortality and all-cause mortality, and moderate certainty for CAD. Conclusions: Based on our current evidence, a higher TyG index may be associated with an increased incidence of CAD (moderate certainty), MI (very low certainty) and CVD (very low certainty) in the general population. There is a potential linear association of the TyG index with CAD and the composite CVD incidence. Further prospective studies (especially in non-Asians) are needed to confirm our findings.

Background Several studies have investigated the impact of body mass index (BMI) on the prognosis of atrial fibrillation, but the results remain controversial. We sought to estimate the association of BMI with atrial fibrillation–related outcomes. Methods and Results We systematically searched the Cochrane Library, PubMed, and Elsevier databases for all studies reporting associations between BMI and atrial fibrillation–related outcomes. Relative risks (RRs) and 95% CIs were extracted and pooled. Nine studies with 49 364 participants were included. Underweight BMI was associated with an increased risk of stroke or systemic embolism (RR 1.67, 95% CI 1.12–2.49), all‐cause mortaliity (RR 2.61, 95% CI 2.21–3.09), and cardiovascular death (RR 2.49, 95% CI 1.38–4.50). Nevertheless, the pooled RRs of overweight and obese patients were lower than those of normal‐weight patients for stroke or systemic embolism (overweight: RR 0.91, 95% CI 0.80–1.04; obese: RR 0.84, 95% CI 0.72–0.98; grade 1 obesity: RR 0.89, 95% CI 0.71–1.11; grade 2 obesity: RR 0.64, 95% CI 0.45–0.91; grade 3 obesity: RR 0.82, 95% CI 0.54–1.25), all‐cause death (overweight: RR 0.78, 95% CI 0.62–0.96; obese: RR 0.84, 95% CI 0.64–1.10; grade 1 obesity: RR 0.64, 95% CI 0.57–0.73; grade 2 obesity: RR 0.70, 95% CI 0.47–1.03; grade 3 obesity: RR 0.72, 95% CI 0.59–0.88), and cardiovascular death (overweight: RR 0.79, 95% CI 0.58–1.08; obese: RR 0.99, 95% CI 0.79–1.24). Conclusions Underweight BMI is associated with an increased risk of stroke or systemic embolism, cardiovascular death, and all‐cause death in Asian patients with atrial fibrillation, whereas in all atrial fibrillation patients, overweight and obese BMI was not associated with increased risks of these outcomes.

Background: The triglyceride and glucose (TyG) index has been linked to various cardiovascular diseases. However, it's still unclear whether the TyG index is associated with arterial stiffness and coronary artery calcification (CAC). Methods: We conducted a systematic review and meta-analysis of relevant studies until September 2022 in the PubMed, Cochrane Library, and Embase databases. We used a random-effects model to calculate the pooled effect estimate and the robust error meta-regression method to summarize the exposure-effect relationship. Results: Twenty-six observational studies involving 87,307 participants were included. In the category analysis, the TyG index was associated with the risk of arterial stiffness (odds ratio [OR]: 1.83; 95% CI 1.55–2.17, I² = 68%) and CAC (OR: 1.66; 95% CI 1.51–1.82, I² = 0). The per 1-unit increment in the TyG index was also associated with an increased risk of arterial stiffness (OR: 1.51, 95% CI 1.35–1.69, I² = 82%) and CAC (OR: 1.73, 95% CI 1.36–2.20, I² = 51%). Moreover, a higher TyG index was shown to be a risk factor for the progression of CAC (OR = 1.66, 95% CI 1.21–2.27, I² = 0, in category analysis, OR = 1.47, 95% CI 1.29–1.68, I² = 41% in continuity analysis). There was a positive nonlinear association between the TyG index and the risk of arterial stiffness (P_nonlinearity < 0.001). Conclusion: An elevated TyG index is associated with an increased risk of arterial stiffness and CAC. Prospective studies are needed to assess causality. Graphical