Accurate severity assessment is crucial in acute cholecystitis, yet commonly used inflammatory markers such as C-reactive protein, white blood cell count, and bilirubin have limited predictive accuracy. The triglyceride–glucose (TyG) index has emerged as a potential biomarker reflecting metabolic stress and inflammation. This retrospective observational study included 134 patients admitted with acute cholecystitis between 2020 and 2024. Disease severity was classified according to the Tokyo Guidelines 2018, and patients were grouped as non-severe (mild–moderate) or severe. Laboratory parameters obtained at admission were analyzed, and the TyG index was calculated as ln (fasting triglyceride × fasting glucose/2). Univariate and multivariable logistic regression analyses and receiver operating characteristic curve analysis were performed. Of the 134 patients, 26 (19.4%) had severe acute cholecystitis. Median fasting glucose ( P = .031) and TyG index values ( P = .029) were higher in the severe group, while triglycerides, C-reactive protein, white blood cell count, and bilirubin showed no significant differences. The TyG index was associated with severe disease in univariate analysis (odds ratio: 1.62; 95% confidence interval: 1.05–2.49; P = .028), but not after multivariable adjustment ( P = .17). Receiver operating characteristic analysis demonstrated an area under the curve of 0.79 (95% confidence interval: 0.71–0.87; P < .001), with an optimal cutoff value of 8.8 (65% sensitivity, 80% specificity). The TyG index was higher in patients with severe acute cholecystitis and demonstrated moderate diagnostic performance. Although not independently associated with disease severity after adjustment, it may serve as an adjunctive marker for early risk stratification, warranting further prospective validation.
Keyif et al. (Fri,) studied this question.