The association between the triglyceride-glucose index and diabetic peripheral neuropathy: a systematic review and meta-analysis

Background Diabetic peripheral neuropathy (DPN) is a prevalent and severe microvascular complication of type 2 diabetes mellitus (T2DM). Early risk screening and warning are critical for slowing disease progression. The triglyceride-glucose (TyG) index, a simple and efficient surrogate marker for assessing insulin resistance (IR), has been proven to be closely associated with various diabetic complications. However, existing studies on the association between the TyG index and the risk of DPN have yielded inconsistent findings, and relevant evidence still lacks systematic synthesis. Methods A systematic review and meta-analysis were conducted. We systematically searched databases including PubMed, Embase, Web of Science, CNKI, Wanfang, and CQVIP to enroll observational studies exploring the association between the TyG index and the risk of DPN in patients with T2DM. Two investigators independently performed literature screening, data extraction, and quality assessment. The random-effects and fixed-effects models were applied to pool effect sizes, and subgroup analyses were carried out to explore potential sources of heterogeneity. Results A total of 14 studies involving 32,281 participants were included. The results showed that a higher TyG index was associated with an increased risk of DPN, with a pooled odds ratio (OR) of 2.614 (95% CI: 1.788-3.821, P P  = 0.0471). This positive correlation remained consistent across most subgroups stratified by age, sample size, BMI, and adjustment for confounding factors. However, the association did not reach statistical significance in the non-China subgroup. Conclusion Elevated TyG levels are associated with an increased risk of DPN in patients with T2DM. However, the causal relationship requires further validation. These findings may serve as a reference for clinical screening of DPN risk. Systematic Review Registration https://www.crd.york.ac.uk/prospero , identifier CRD420261373476.