Background

The triglyceride-glucose index (TyG), and TyG-driven parameters incorporating TyG and obesity indices have been proposed as reliable indicators of insulin resistance and its related comorbidities. This study evaluated the effectiveness of these indices in identifying hepatic steatosis in individuals with Type 2 diabetes (T2DM).

Methods

This was a cross-sectional study consisting of 175 patients with T2DM (122 with and 53 without NAFLD). TyG index, triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR) were determined using standard formulas. Controlled attenuation parameter (CAP) was measured by transient elastography (FibroScan).

Results

Among obesity parameters, CAP showed the strongest correlation with WHtR, followed by BMI and WC (all P < 0.001). Regression analyses demonstrated TyG-WHtR as a significant predictor of NAFLD with the highest odds ratio, reaching 10.69 (95% CI: 1.68–68.22) for the top quartile (Q4) compared to the first quartile (P = 0.01), followed by TyG-BMI (Q4: 6.75; 95% CI: 1.49–30.67) and TyG-WC (Q4: 5.90; 95% CI: 0.99–35.18). Moreover, TyG-WHtR presented the largest AUC for detection of NAFLD (0.783, P < 0.001) in ROC analysis, followed by TyG-BMI (AUC: 0.751, P < 0.001), TyG-WC (AUC: 0.751, P < 0.001), and TyG (AUC: 0.647, P = 0.002). TyG-WHtR value of 5.58 (sensitivity: 79%, specificity: 68%, P < 0.001) was the best cut-off point to identify hepatic steatosis in this population.

Conclusions

This study confirmed that the TyG-related indices comprising TyG and obesity parameters can identify hepatic steatosis more successfully than TyG alone. Furthermore, our results highlighted TyG-WHtR as a simple and effective marker for screening fatty liver in patients with T2DM, which may be used practically in clinical setting.

中文翻译：

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甘油三酯葡萄糖腰高比：一种识别 2 型糖尿病患者肝脏脂肪变性的新型有效标志物

背景

甘油三酯-葡萄糖指数 (TyG) 和结合 TyG 和肥胖指数的 TyG 驱动参数已被提议作为胰岛素抵抗及其相关合并症的可靠指标。本研究评估了这些指标在识别 2 型糖尿病 (T2DM) 患者肝脏脂肪变性方面的有效性。

方法

这是一项横断面研究，包括 175 名 T2DM 患者（122 名患有 NAFLD，53 名未患有 NAFLD）。TyG 指数、甘油三酯葡萄糖体重指数 (TyG-BMI)、甘油三酯葡萄糖腰围 (TyG-WC) 和甘油三酯葡萄糖腰围身高比 (TyG-WHtR) 使用标准公式确定。通过瞬态弹性成像 (FibroScan) 测量受控衰减参数 (CAP)。

结果

在肥胖参数中，CAP 与 WHtR 的相关性最强，其次是 BMI 和 WC（均P  < 0.001）。回归分析表明，TyG-WHtR 是 NAFLD 的重要预测因子，比值比最高，与第一四分位数 ( P  = 0.01)相比，最高四分位数 (Q4) 达到 10.69（95% CI：1.68–68.22 ），其次是 TyG -BMI（Q4：6.75；95% CI：1.49–30.67）和 TyG-WC（Q4：5.90；95% CI：0.99–35.18）。此外， 在 ROC 分析中，TyG-WHtR 显示出检测 NAFLD 的最大 AUC（0.783，P < 0.001），其次是 TyG-BMI（AUC：0.751，P  < 0.001），TyG-WC（AUC：0.751，P  < 0.001） ), 和 TyG (AUC: 0.647, P = 0.002）。TyG-WHtR 值为 5.58（敏感性：79%，特异性：68%，P  < 0.001）是在该人群中识别肝脂肪变性的最佳截止点。

结论

该研究证实，与单独的 TyG 相比，包含 TyG 和肥胖参数的 TyG 相关指数可以更成功地识别肝脏脂肪变性。此外，我们的结果强调了 TyG-WHtR 作为筛查 T2DM 患者脂肪肝的简单有效的标志物，可在临床环境中实际使用。