Predictive value of triglyceride glucose index combined with BMI to identify NAFLD in T2D Highlights This cross-sectional study investigated the predictive value of triglyceride glucose body mass index and the occurrence of nonalcoholic fatty liver disease (NAFLD) in 826 Chinese patients with type 2 diabetes. The association between glucose/triglyceride index (TyG), TyG-BMI index, insulin resistance index (HOMA-IR) and triglyceride to high-density lipoprotein cholesterol ratio with diagnosis of NAFLD was estimated. through logistic regression analysis. The findings of this study demonstrate that, compared with TyG index, TG/HDL-C, and HOMA-IR, TyG-BMI is a more effective predictor of NAFLD in type 2 diabetes. |
Nonalcoholic fatty liver disease (NAFLD) is a clinical entity characterized by hepatic steatosis after exclusion of significant alcohol consumption and other chronic liver diseases. If the disease progresses, it could progress to liver fibrosis and even liver cancer.
Several studies have shown that NAFLD is related to diseases such as type 2 diabetes, abdominal obesity, dyslipidemia, hypertension and cardiovascular diseases, and is closely related to insulin resistance (IR) and genetic susceptibility to Liver injury induced by metabolic stress.
Furthermore, mitochondrial dysfunction also plays a key role in the onset and development of NAFLD, among which, sirtuin-4 is a preeminent factor as evident in the negative regulator of oxidative metabolism of mitochondria.
Background
The triglyceride/glucose index combined with body mass index is a new index that reflects the degree of insulin resistance. In this cross-sectional study, we aimed to explore the predictive value of body mass index/glucose/triglycerides (TyG-BMI) in relation to the occurrence of non-alcoholic fatty liver disease (NAFLD) in the Chinese population with type 2 diabetes. .(DT2).
Methods
We selected 826 patients with T2D who were hospitalized in the Department of Endocrinology and Metabolism of Karamay People’s Hospital from September 2016 to October 2018 for this research. Subjects’ height, weight, fasting blood glucose, serum insulin, and lipid profiles were collected.
Liver ultrasound showed any degree of echogenic enhancement of the liver tissue and the liver appeared brighter than the renal cortex on ultrasound and was considered NAFLD. Logistic regression analysis was performed to estimate associations between the triglyceride glucose index (TyG), the TyG-BMI index , the insulin resistance index (HOMA-IR) and the ratio of triglycerides to high-density lipoproteins. cholesterol with a diagnosis of NAFLD. The receiver operating characteristic curve method was used to analyze its predictive value for NAFLD.
- HOMA-IR is calculated as follows: HOMA-IR = fasting insulin (μU/dL) × fasting blood glucose (mg/dL)/22.5.
- TyG index: Ln [TG (mg/dL) × fasting blood glucose (mg/dL)/2].
- The TyG-BMI represents the TyG × BMI index
Results
The results of logistic regression analysis showed that the odds ratios of NAFLD were 6.535 (3.70–11.53) and 4.868 (2.576–9.200) for TyG-BMI before and after correction, respectively (P < 0.001). .
The area under the curve (AUC) for TyG-BMI was 0.727 (0.691-0.764), which was the highest among all other parameters studied.
Conclusion
A very high proportion of patients with type 2 diabetes have NAFLD. In our study, almost 67% of T2D patients had NAFLD. Therefore, it is worth searching for effective markers of NAFLD in patients with T2D.
TyG-BMI is a valuable index for the detection of NAFLD and is an effective non-invasive method for identifying NAFLD.
To improve the prediction performance of NAFLD in patients with T2D, it can be predicted at low cost using values obtained from routine laboratory tests. Therefore, we recommend applying the TyG-BMI value to the assessment of NAFLD risk in people with T2D in clinical practice and in future epidemiological studies.
Final message
Compared with TyG index, TG/HDL-C, and HOMA-IR, TyG-BMI was a more effective predictor of NAFLD in T2D.
