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Association between triglyceride glucose-body mass index and non-alcoholic fatty liver disease in the non-obese Chinese population with normal blood lipid levels: a secondary analysis based on a prospective cohort study.

ABSTRACT: BACKGROUND:Both triglyceride glucose-body mass index (TyG-BMI) and non-alcoholic fatty liver disease (NAFLD) are linked to insulin resistance (IR). Prospective studies linking TyG-BMI to NAFLD have been limited by short follow-up. This study investigated the longitudinal association between TyG-BMI and NAFLD occurrence in the non-obese Chinese individuals. METHODS:This study determined TyG-BMI at baseline and the incidence of NAFLD at follow-up and performed a post hoc analysis of a prospective cohort study that involved assessing the risk of NAFLD in non-obese Chinese residents from January 2010 to December 2014. The incidence of NAFLD during the 5-year follow-up was identified as the endpoint. Cox proportional hazards regression analysis was used to evaluate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the incidence of NAFLD. Receiver operating characteristic (ROC) curve analysis was conducted to estimate the predictive power of TyG-BMI and its components for NAFLD. Subgroup analysis was performed to better understand other factors that may affect the association between TyG-BMI and NAFLD to identify potential special populations. RESULTS:During the follow-up period, 841 (8.61%) of 9767 non-obese subjects who met the screening criteria were diagnosed with NAFLD. After confounding factors were fully adjusted for, the HR of NAFLD was 3.09 (95% CI 2.63-3.63) per standard deviation (SD) increase in TyG-BMI. Furthermore, TyG-BMI had a strong predictive value (area under ROC?=?0.85; 95% CI 0.84-0.86) for the incidence of NAFLD, with a specificity of 0.73 and sensitivity of 0.82. Additionally, in the male population, each SD increase in TyG-BMI was linked to an increased risk of NAFLD (HR?=?2.85, 95% CI 2.30-3.53), but the risk was higher in the female population (HR?=?3.58, 95% CI 2.80-4.60). Gender and TyG-BMI interacted significantly with NAFLD incidence (P?

SUBMITTER: Li Y

PROVIDER: S-EPMC7592551 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Association between triglyceride glucose-body mass index and non-alcoholic fatty liver disease in the non-obese Chinese population with normal blood lipid levels: a secondary analysis based on a prospective cohort study.

Li Yaling Y Zheng Rui R Li Jie J Feng Shuyi S Wang Li L Huang Zhiming Z

Lipids in health and disease 20201028 1

<h4>Background</h4>Both triglyceride glucose-body mass index (TyG-BMI) and non-alcoholic fatty liver disease (NAFLD) are linked to insulin resistance (IR). Prospective studies linking TyG-BMI to NAFLD have been limited by short follow-up. This study investigated the longitudinal association between TyG-BMI and NAFLD occurrence in the non-obese Chinese individuals.<h4>Methods</h4>This study determined TyG-BMI at baseline and the incidence of NAFLD at follow-up and performed a post hoc analysis of ...[more]

PMID: 33109219

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Project description:BackgroundBy identifying individuals at high risk for non-alcoholic fatty liver disease (NAFLD), interventional programs could be targeted more effectively. Some studies have demonstrated that triglyceride glucose-body mass index (TyG-BMI) showed an independent positive association with NAFLD. However, research on its diagnostic value in patients with suspected NAFLD is limited. In this study, we aimed to evaluate whether TyG-BMI was accurate in detecting NAFLD in the general Japanese population.MethodsA cross-sectional study of 14,280 individuals who underwent a comprehensive health examination was conducted. Standard protocols were followed to collect anthropometric measurements, lab data, and ultrasonography features. All participants were randomly stratified into the development group (n = 7118) and validation group (n = 7162). The TyG-BMI was calculated. Following this, the diagnostic value of the TyG-BMI was evaluated based on the area under the receiver-operating characteristic curve (AUROC). Two cutoff points were selected and used to rule out or rule in the NALFD, and the specificity, sensitivity, negative predictive value, and positive predictive value were explored, respectively. In order to verify the stability of the results, external verification was performed.ResultsThere were 1272 and 1243 NAFLD participants in the development and validation groups, respectively. The area under the ROC curve (AUC) of TyG-BMI was 0.888 (95% CI 0.876-0.896) and 0.884 (95% CI 0.875-0.894) for the training and validation group, respectively. Using the low TyG-BMI (182.2) cutoff, NAFLD could be excluded with high accuracy (negative predictive value: 96.9% in estimation and 96.9% in validation). The presence of NAFLD could effectively be determined by applying the high cutoff of TyG-BMI (224.0), as the positive predictive value of the estimation and validation groups is 70.7% and 70.1%, respectively. As a result of applying this model, 9996 (70%) of the 14,280 participants would not have undergone ultrasonography, with an accurate prediction of 9308 (93.1%). AUC was 0.874 for external validation using 183,730 Chinese non-obese participants. TyG-BMI was demonstrated to be an excellent diagnostic tool by both internal and external validation.ConclusionsIn conclusion, the present study developed and validated a simple, non-invasive, and cost-effective tool to accurately separate participants with and without NAFLD in the Japanese population, rendering ultrasonography for identifying NAFLD unnecessary in a substantial proportion of people.

Dataset Information

Association between triglyceride glucose-body mass index and non-alcoholic fatty liver disease in the non-obese Chinese population with normal blood lipid levels: a secondary analysis based on a prospective cohort study.

Publications

Association between triglyceride glucose-body mass index and non-alcoholic fatty liver disease in the non-obese Chinese population with normal blood lipid levels: a secondary analysis based on a prospective cohort study.

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