Usefulness of the Triglyceride Glucose Index to Predict Nonalcoholic Fatty Liver Disease in Children With Obesity

Abstract

Song et al 1Song K. Park G. Lee H.S. Lee M. Lee H.I. Choi H.S. et al.Comparison of the triglyceride glucose index and modified triglyceride glucose indices to predict nonalcoholic fatty liver disease in youths.J Pediatr. 2022; 242: 79-85Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar reported the usefulness of triglyceride glucose (TyG) index and modified TyG indices in predicting nonalcoholic fatty liver disease (NAFLD) in general Korean youths aged 10-19 years. The TyG index, calculated from fasting glucose and triglyceride levels, has high sensitivity and specificity for identifying insulin resistance. 2Guerrero-Romero F. Simental-Mendia L.E. Gonzalez-Ortiz M. Martinez-Abundis E. Ramos-Zavala M.G. Hernandez-Gonzalez S.O. 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: 3347-3351Crossref PubMed Scopus (527) Google Scholar This study found the TyG index and modified TyG indices significantly predicted pediatric NAFLD. Area under the receiver operating characteristic (AUROC) values for NAFLD detection ranged from 0.667 to 0.780 as follows: TyG, 0.667; TyG-BMI, 0.774; TyG-BMI SDS, 0.774; TyG-waist circumference (WC), 0.776; and TyG-waist-to-height ratio (WHtR), 0.780. All modified TyG indices outperformed the original TyG indices in predicting NAFLD. Based on these observations, we further analyzed the predictive power of the original and modified TyG indices for NAFLD detection in children with obesity. We recruited 1233 obese children aged 6 to 18 years in Taipei, Taiwan. Using redefined ALT cutoffs derived from metabolically healthy Taiwanese children (23 U/L in boys and 18 U/L in girls), 3Lin Y.C. Chang P.F. Ni Y.H. Updated upper limits of normal serum alanine aminotrasferase levels for screening metabolic dysfunction-associated fatty liver disease in obese children.J Formos Med Assoc. J Formos Med Assoc. 2022; https://doi.org/10.1016/j.jfma.2022.06.002Crossref Scopus (1) Google Scholar the estimated prevalence of NAFLD was 46.9% in obese boys and 31.1% in obese girls. AUROC values of the original and modified TyG indices ranged from 0.616 to 0.674 as follows: TyG, 0.616; TyG-BMI, 0.674; TyG-BMI SDS, 0.648; TyG-WC, 0.673; and TyG-WHtR, 0.670. Consistent with the data of Song et al., AUROC values of the TyG-BMI, TyG-WC and TyG-WHtR indices were significantly higher than those of the TyG index in our obese cohort. Our data and the data of Song et al support the usefulness of the original and modified TyG indices as potential biomarkers for pediatric NAFLD screening. However, AUROC values of the TyG index and modified TyG indices are not high, indicating that perhaps other biomarkers should be combined to improve the prediction accuracy.