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Triglyceride Glucose-Waist Circumference Is Superior to the Homeostasis Model Assessment of Insulin Resistance in Identifying Nonalcoholic Fatty Liver Disease in Healthy Subjects.

ABSTRACT: The triglyceride glucose (TyG) index has been suggested as a marker for insulin resistance; however, few studies have investigated the clinical implications of markers that combine obesity markers with the TyG index. This study aimed to investigate the associations between non-alcoholic fatty liver disease (NAFLD) and TyG-related markers in healthy subjects in Korea. We enrolled 21,001 asymptomatic participants who underwent hepatic ultrasonography. The homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-body mass index, and TyG-waist circumference (WC) were subsequently analyzed. NAFLD was diagnosed using hepatic ultrasonography. A multiple logistic regression analysis was performed to evaluate the associations between the quartiles of each parameter and the risk of NAFLD. The increase in the NAFLD risk was most evident when the TyG-WC quartiles were applied; the multivariate-adjusted odds ratios for NAFLD were 4.72 (3.65-6.10), 13.28 (10.23-17.24), and 41.57 (31.66-54.59) in the 2nd, 3rd, and 4th TyG-WC quartiles, respectively, when compared with the lowest quartile. The predictability of the TyG-WC for NAFLD was better than that of the HOMA-IR using the area under the curve. The TyG-WC index was superior to the HOMA-IR for identifying NAFLD in healthy Korean adults, especially in the non-obese population.

SUBMITTER: Kim HS

PROVIDER: S-EPMC8745545 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe triglyceride and glucose-waist circumference (TyG-WC) index demonstrated a strong association with insulin resistance, especially in Asian population. However, evidence on the association between TyG-WC index and the occurrence of cardiovascular disease (CVD) is limited. This study aimed to verify association between the TyG-WC index and the occurrence of CVD by considering all-cause mortality as a competing risk.MethodsThe study included 7482 participants divided into four groups based on the TyG-WC index quartiles. Kaplan-Meier curves illustrated cumulative incidence rates of CVD and all-cause mortality during the follow-up period. Log-rank tests determined group differences. The Cox proportional hazard spline curve demonstrates the dose-dependent relationship between the TyG-WC index and incident CVD. Modified Cox regression (Fine and Gray) estimated hazard ratios (HRs) with 95% CIs for incident CVD, treating death as a competing risk. Death event after incident CVD was excluded from the death count.ResultsDuring the median 15.94 year of follow-up period, a total of 691 (9.24%) new-onset CVD cases and 562 (7.51%) all-cause mortality cases were confirmed. Cox proportional hazard spline curves suggested that TyG-WC index exhibited a dose-dependent positive correlation with incident CVD. The cumulative incidence rate of CVD was significantly higher in the groups with higher TyG-WC index quartiles in Kaplan-Meier curves. The adjusted HR (95% CI) for incident CVD in Q2-Q4, compared with Q1, was 1.47 (1.12-1.93), 1.91 (1.44-2.54) and 2.24 (1.63-3.07), respectively. There was no significant association between TyG-WC index and all-cause mortality. Specifically, angina and stroke were significantly associated with the TyG-WC index, in contrast to myocardial infarction and peripheral artery disease.ConclusionsThe TyG-WC index was positively associated with incident CVD even considering all-cause mortality as a competing risk. Therefore, TyG-WC index may be a valuable marker for predicting the occurrence of CVD.

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Triglyceride Glucose-Waist Circumference Is Superior to the Homeostasis Model Assessment of Insulin Resistance in Identifying Nonalcoholic Fatty Liver Disease in Healthy Subjects.

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