Predictive significance of the triglyceride glucose index and associated indicators for hepatic steatosis in type 2 diabetes patients with diverse body mass index
Abstract
Introduction: The objective was to explore the value of triglyceride glucose index and related indicators in predicting hepatic steatosis in type 2 diabetes patients (T2DM) with different body mass indexes (BMI).
Material and methods: Clinical data from 221 hospitalised patients withT2DM, diagnosed with hepatic steatosis via transient elastography, were collected and analysed. Patients with a BMI of 24 kg/m² or higher were designated as the high-BMI group, while those with a BMI below 24 kg/m² comprised the low-BMI group. Relevant indicators, including triglyceride glucose index (TyG), TyG-BMI index (TyG-BMI),
and TyG-waist circumference (TyG-WC), were obtained.
Results: TyG, TyG-BMI, and TyG-WC were all significantly elevated in the high-BMI group relative to the low-BMI group (p < 0.01).Within both high- and low-BMI categories of T2DM patients, TyG, TyG-BMI, and TyG-WC were markedly higher in patients with hepatic steatosis than in those without the condition (p < 0.01 or p < 0.05). Multivariate logistic regression analysis identified TyG-BMI as an independent
risk factor for hepatic steatosis in high-BMI T2DM patients (p < 0.01), while glycosylated haemoglobin (HbA1c) and TyG-WC emerged as independent risk factors in low-BMI T2DM patients (p < 0.01 or p < 0.05). Receiver operating characteristic curve analysis for predicting hepatic steatosis in high-BMI T2DM patients demonstrated that TyG-BMI had an area under the curve of 0.84 (p < 0.01) with a cut-off value of 241.36, yielding a sensitivity of 79.80% and a specificity of 83.30%. For low-BMI T2DM patients, the TyG-WC index had an area under the curve of 0.80 (p < 0.01), a cut-off value of 824.63, a sensitivity of 68.30%, and a specificity of 84.90%.
Conclusion: In T2DM patients, TyG-BMI can predict hepatic steatosis in high-BMI patients, and TyG-WC can predict hepatic steatosis in low-BMI patients. The latter is negatively correlated with HbA1c.
Keywords: diabetes mellitus type 2hepatic steatosisbody mass indextriglyceride glucose-body mass indextriglyceride glucose-waist circumference index
References
- Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020; 73(1): 202–209.
- Xue Y, Xu J, Li M, et al. Potential screening indicators for early diagnosis of NAFLD/MAFLD and liver fibrosis: Triglyceride glucose index-related parameters. Front Endocrinol (Lausanne). 2022; 13: 951689.
- Li X, Zhou ZG, Qi HY, et al. [Replacement of insulin by fasting C-peptide in modified homeostasis model assessment to evaluate insulin resistance and islet beta cell function]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2004; 29(4): 419–423.
- Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010; 95(7): 3347–3351.
- Qu Y, Song YY, Chen CW, et al. Diagnostic Performance of FibroTouch Ultrasound Attenuation Parameter and Liver Stiffness Measurement in Assessing Hepatic Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clin Transl Gastroenterol. 2021; 12(4): e00323.
- Guo K, Zhang L, Lu J, et al. Non-alcoholic fatty liver disease is associated with late but not early atherosclerotic lesions in Chinese inpatients with type 2 diabetes. J Diabetes Complications. 2017; 31(1): 80–85.
- Riddle MC, Cefalu WT, Evans PH, et al. Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes. Diabetes Care. 2021 [Epub ahead of print]; 44(10): 2438–2444.
- American Diabetes Association Professional Practice Committee. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2024. Diabetes Care. 2024; 47(Suppl 1): S52–S76.
- Hernández-Conde M, Llop E, Carrillo CF, et al. Estimation of visceral fat is useful for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease. World J Gastroenterol. 2020; 26(42): 6658–6668.
- Sakurai Y, Kubota N, Yamauchi T, et al. Role of Insulin Resistance in MAFLD. Int J Mol Sci. 2021; 22(8).
- Gilani A, Stoll L, Homan EA, et al. Adipose Signals Regulating Distal Organ Health and Disease. Diabetes. 2024; 73(2): 169–177.
- Xia X, Chen S, Tian X, et al. Association of triglyceride-glucose index and its related parameters with atherosclerotic cardiovascular disease: evidence from a 15-year follow-up of Kailuan cohort. Cardiovasc Diabetol. 2024; 23(1): 208.
- Chen Q, Hu P, Hou X, et al. Association between triglyceride-glucose related indices and mortality among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease. Cardiovasc Diabetol. 2024; 23(1): 232.
