Triglyceride-glucose index and structural chromosome aberrations in medical radiation workers: a cross-sectional study with a stratified dosimetry substudy.

Background: Metabolic status may be associated with variation in cytogenetic outcomes among occupationally exposed workers. We examined the cross-sectional association between the triglyceride-glucose (TyG) index and structural chromosome aberration burden among medical radiation workers. Methods: This retrospective cross-sectional study included 23,408 medical radiation workers and 6,542 healthcare controls without occupational radiation duties. The primary outcome was the number of structural chromosome aberrations per 100 metaphases, analyzed using negative binomial regression. A stratified dosimetry substudy of 1,500 medical radiation workers incorporated recorded cumulative occupational dose, with inverse-probability weighting used as a sensitivity analysis for unequal sampling fractions across occupational categories. Results: Among medical radiation workers, each 1-SD increase in TyG was associated with a higher structural chromosome aberration count after multivariable adjustment (adjusted IRR, 1.15; 95% CI, 1.09-1.22). Compared with the lowest TyG quartile, the adjusted IRR was 1.52 (95% CI, 1.27-1.83) for the highest quartile ( Conclusions: Higher TyG was associated with a greater structural chromosome aberration count among medical radiation workers, including after adjustment for recorded cumulative occupational dose. The cross-sectional design, incomplete exposure characterization, and potential residual confounding preclude causal interpretation or use of TyG for individual occupational risk stratification.