Association between triglyceride-glucose index-related indices and gallstone disease in US adults: A cross-sectional analysis of NHANES.

The triglyceride-glucose (TyG) index and its obesity-related derivatives-TyG-body mass index, TyG-waist circumference, TyG-waist-to-height ratio (TyG-WHtR), and TyG-a body shape index (TyG-ABSI)-are emerging surrogates of insulin resistance. Their relationships with gallstone disease in the general population remain unclear. We investigated the associations between TyG-related indices and gallstone disease and compared their discriminatory performance. We performed a cross-sectional analysis of 6551 adults from the 2017 to 2023 National Health and Nutrition Examination Survey. Gallstone disease was defined as a self-reported diagnosis by a physician or other health professional. TyG and its 4 derivatives were calculated from fasting triglycerides, fasting plasma glucose, and anthropometric measures. Survey-weighted multivariable logistic regression was used to estimate odds ratios and 95% confidence intervals for gallstone disease, with stepwise adjustment for sociodemographic, lifestyle, and cardiometabolic covariates. Restricted cubic splines evaluated potential nonlinear dose-response relationships, and receiver operating characteristic curves were used to assess predictive performance. The weighted prevalence of gallstone disease was 10.8% (709/6551). All TyG-related indices were significantly higher in participants with gallstones than in those without (all P < .001). In fully adjusted models, each 1-unit increase in TyG, TyG-WHtR, and TyG-ABSI was associated with 40%, 58%, and 21% higher odds of gallstone disease, respectively (odds ratio [95% confidence interval]: 1.40 [1.15, 1.70], 1.58 [1.41, 1.78], and 1.21 [1.02, 1.44]). Quartile analyses showed clear dose-response patterns for all 5 indices. Receiver operating characteristic analyses indicated that TyG-WHtR had the greatest discriminative ability (area under the curve 0.672), followed by TyG-body mass index (0.649) and TyG-waist circumference (0.643), whereas TyG and TyG-ABSI demonstrated lower area under the curves (~0.59-0.60). Higher levels of the TyG index and its derived measures are independently associated with gallstone disease in US adults. Among these markers, TyG-WHtR shows the best, though modest, performance for identifying individuals at higher gallstone risk.