ABSTRACT Background/Objective Gallstone disease (GSD) is a common hepatobiliary condition closely associated with metabolic disturbances. The triglyceride–glucose index (TyG index), a widely used surrogate marker of insulin resistance, has gained attention as a potential indicator of gallstone risk. This systematic review and meta‐analysis aimed to synthesize observational evidence evaluating the association between TyG index and GSD in adults. Methods Web of Science, Embase, and PubMed were searched from inception to December 2025 for relevant observational studies. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Adjusted odds ratios (aORs), standardized mean differences (SMDs), adjusted hazard ratios (aHRs), and prevalence estimates were pooled using a random‐effects model (REM). Sensitivity analyses, subgroup analyses, and assessment of publication bias were conducted. Results Nine studies including more than 430 000 participants were included. For each one‐unit increase in the TyG index, the pooled odds ratio for GSD was 1.332 (95% CI: 1.213–1.462; I 2 = 0%). When comparing the highest versus lowest TyG categories, the summary OR was 1.678 (95% CI: 1.150–2.448). Participants with GSD had higher TyG values than those without GSD (pooled SMD: 0.29; 95% CI: 0.26–0.32). The pooled prevalence of GSD was 10.51% (95% CI: 5.40–19.44), with heterogeneity ( I 2 = 99.8%). Subgroup analyses were performed according to body mass index (BMI), sex, diabetes, and race. Conclusion Higher TyG index values are consistently linked to elevated risk of GSD. Given that TyG is inexpensive and routinely available, it may be useful for identifying individuals at a heightened risk of GSD. More longitudinal studies are needed to determine causation and to assess whether TyG‐based screening can improve GSD risk prediction or prevention.
Gupta et al. (Sun,) studied this question.