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

Hwi Seung Kim,Hong-Kyu Kim,Min Jung Lee,Chang Hee Jung,Eun Hee Kim,Woo Je Lee,Yun Kyung Cho,Joong-Yeol Park

doi:10.3390/jcm11010041

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.

Highlights

While simple steatosis is regarded as benign [7,9], a subset of nonalcoholic fatty liver disease (NAFLD) patients develop nonalcoholic steatohepatitis (NASH), which is a more unfavorable condition, as it may progress to fibrosis and cirrhosis, both of which have serious clinical consequences [10]
We discovered that people with high triglyceride glucose (TyG)-related indices were more likely to have NAFLD, and these indices were more effective than homeostasis model assessment of insulin resistance (HOMA-Insulin resistance (IR)) for detecting
We found that the discriminative value of the TyG-waist circumference (WC) was higher for the non-obese patients in our subgroup analyses

Summary

Introduction

IR is a key contributor to the pathophysiology of nonalcoholic fatty liver disease (NAFLD), which has recently been recognized as a hepatic component of metabolic syndrome [4]. It has recently suggested that NAFLD is a systemic disease which plays a critical role in metabolic syndrome; the concept metabolic-dysfunction-associated fatty liver disease (MAFLD) has been proposed [5]. While simple steatosis is regarded as benign [7,9], a subset of NAFLD patients develop nonalcoholic steatohepatitis (NASH), which is a more unfavorable condition, as it may progress to fibrosis and cirrhosis, both of which have serious clinical consequences [10]. NASH is a chronic and progressive disease, which can predispose patients to develop liver cirrhosis and hepatocellular carcinoma (HCC) [11]

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