Association between triglyceride-glucose index and gastroesophageal reflux disease: a health checkup cohort study

The triglyceride-glucose (TyG) index was proposed as a useful marker of metabolic syndrome. Insulin resistance, which is the main mechanism underlying metabolic syndrome, is related to the gastroesophageal reflux disease (GERD). This study aimed to elucidate the association between the TyG index and GERD. We retrospectively reviewed the electronic medical records of patients who underwent gastroduodenoscopy at a checkup center. The calculation of TyG index used following formula: ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). We divided the patients into four groups according to the TyG index quartile (Q). We evaluated the relationship between the alteration of the TyG index and GERD in patients who received health checkup two times. Among the 52,605 enrolled patients, 3,073 (5.8%) were diagnosed with GERD. The odds ratios (ORs) for GERD in the TyG index progressively increased across quartiles (P < 0.001): Q2 (OR = 2.477), Q3 (OR = 3.013), and Q4 (OR = 4.027) compared with Q1, which was used as a reference. Male, obesity, smoking, alcohol consumption, and hypertension were also predictive factors for GERD. Moreover, the degree of TyG index increase during the first and second tests in the GERD group was more prominent than that in the control group (P = 0.001). In conclusion, the higher TyG index was significantly associated with GERD. The TyG index may be a novel predictive biomarker of GERD.