Improvement of Triglyceride–Glucose Index Following Bariatric Surgery: a Systematic Review and Meta-analysis

Abstract

Background: Bariatric surgery is an effective intervention for the management of severe obesity and its associated comorbidities, including metabolic abnormalities. This meta-analysis aimed to evaluate the impact of bariatric surgery on the triglyceride-glucose (TyG) index, a novel marker of insulin resistance and metabolic syndrome. Methods: A systematic search was conducted in Embase, PubMed, Web of Science, and Scopus. The meta-analysis was performed using Comprehensive Meta-Analysis (CMA) V4 software. The overall effect size was determined by a random-effects meta-analysis and the leave-one-out approach. Results: A total of 9 trials including 1620 individuals confirmed a significant reduction in TyG following bariatric surgery (weighted mean difference (WMD) − 0.770, 95% CI − 1.006, − 0.534, p < 0.001). In a sub-analysis according to the type of bariatric surgery there was a significant reduction in TyG index for Roux-en-Y gastric bypass (WMD − 0.775, 95% CI − 1.000, − 0.550, p < 0.001), and sleeve gastrectomy (WMD − 0.920, 95% CI − 1.368, − 0.473, p < 0.001). In a sub-analysis according to the follow-up duration there was similarly a significant reduction in TyG index for both < 12 months (WMD − 1.645, 95% CI − 2.123, − 1.167, p < 0.001), and ≥ 12 months follow-up (WMD − 0.954, 95% CI − 1.606, − 0.303, p < 0.001). Conclusion: The results of this meta-analysis demonstrated a significant reduction in the TyG index following bariatric surgery, indicating improved insulin sensitivity and metabolic health. These findings highlight the potential of bariatric surgery as a valuable therapeutic option for individuals with obesity and its metabolic consequences. Graphical Abstract: (Figure presented.)