甘油三酯-葡萄糖指数与子痫前期风险：一项系统评价和荟萃分析。
完整摘要 · 中文译文
胰岛素抵抗在子痫前期（PE）中起作用，但甘油三酯-葡萄糖（TyG）指数的临床效用尚不清楚。本系统综述和荟萃分析评估了TyG指数与PE之间的关联及其诊断准确性。我们检索了8个数据库，纳入自建库至2025年12月31日发表的观察性研究。采用随机效应模型汇总数据，并通过亚组分析和敏感性分析处理异质性。我们的分析纳入12项研究，涉及103,702名孕妇。较高的TyG指数与PE几率增加相关，合并比值比为1.85（95% CI：1.48-2.32）。研究间观察到显著异质性（I² = 71.2%）。在5项研究中，合并灵敏度为0.65（95% CI：0.49-0.78），特异度为0.58（95% CI：0.50-0.65），汇总受试者工作特征曲线下面积为0.64（95% CI：0.59-0.68），提示区分能力有限。局限性包括显著异质性、以中国人群为主，以及部分研究中TyG测量在PE发病接近时或之后进行。虽然TyG指数是与PE相关的探索性代谢标志物，但这些发现并未证实其前瞻性预测价值，也不支持将其用作独立筛查工具。其对多变量预测模型的增量贡献需要在不同人群中采用标准化测量时机和预设阈值进行前瞻性验证。
完整摘要 · 英文原文
Insulin resistance plays a role in preeclampsia (PE), yet the clinical utility of the triglyceride-glucose (TyG) index is unclear. This systematic review and meta-analysis evaluated the association between the TyG index and PE, as well as its diagnostic accuracy. We searched eight databases for observational studies published from inception to December 31, 2025. Data were synthesized using random-effects models, with subgroup and sensitivity analyses addressing heterogeneity. Our analysis included 12 studies involving 103,702 pregnant women. A higher TyG index was linked to increased odds of PE, with a pooled odds ratio of 1.85 (95% CI: 1.48-2.32). Significant heterogeneity was observed across studies (I² = 71.2%). In five studies, the pooled sensitivity was 0.65 (95% CI: 0.49-0.78), specificity was 0.58 (95% CI: 0.50-0.65), and the area under the summary receiver operating characteristic curve was 0.64 (95% CI: 0.59-0.68), suggesting limited discriminatory power. Limitations included substantial heterogeneity, a predominance of Chinese populations, and TyG measurements taken near or after PE onset in some studies. While the TyG index is an exploratory metabolic marker associated with PE, these findings do not confirm its prospective predictive value or support its use as a standalone screening tool. Its incremental contribution to multivariable prediction models requires prospective validation in diverse populations, using standardized measurement timing and predefined thresholds.