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甘油三酯葡萄糖指数及相关参数(甘油三酯葡萄糖-体重指数和甘油三酯葡萄糖-腰围)可识别超重/肥胖个体的非酒精性脂肪肝和肝纤维化。

Triglyceride Glucose Index and Related Parameters (Triglyceride Glucose-Body Mass Index and Triglyceride Glucose-Waist Circumference) Identify Nonalcoholic Fatty Liver and Liver Fibrosis in Individuals with Overweight/Obesity.

机构信息

Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

出版信息

Metab Syndr Relat Disord. 2021 Apr;19(3):167-173. doi: 10.1089/met.2020.0109. Epub 2020 Dec 1.


DOI:10.1089/met.2020.0109
PMID:33259744
Abstract

The triglyceride glucose (TyG) index has been proposed as a reliable surrogate marker for nonalcoholic fatty liver disease (NAFLD). Furthermore, NAFLD is strongly related with obesity. This study aimed to compare TyG index and its related parameters (TyG-waist circumference [WC] and TyG-body mass index [BMI]), comprising TyG and obesity markers, in predicting NAFLD and liver fibrosis in overweight/obese individuals without diabetes. This was a cross-sectional study consisting of 184 overweight/obese people (96 with and 88 without NAFLD), 30-65 years of age. TyG, TyG-BMI, and TyG-WC were computed using the established formula. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were determined by transient elastography (FibroScan). In correlation analyses, CAP and LSM were significantly associated with WC, BMI, TyG, TyG-BMI, and TyG-WC. Regression analyses highlighted TyG-WC as a significant predictor of NAFLD, with the highest standardized odds ratio (2.25,  < 0.001); while liver fibrosis was associated more strongly with TyG-BMI. In receiver operating characteristic (ROC) analysis, TyG-WC showed the largest area under the ROC curve (AUC) for detection of NAFLD (0.693, 95% confidence interval [CI]: 0.617-0.769). However, TyG-BMI was a better discriminator of liver fibrosis (AUC: 0.635, 95% CI: 0.554-0.714). TyG-WC value of 876 (sensitivity: 81.3%, specificity: 52.3%) and TyG-BMI value of 259 (sensitivity: 78.3%, specificity: 51.3%) were the optimal cutoff points to predict NAFLD and liver fibrosis, respectively. The results highlight the significant associations of TyG and its related indices with NAFLD, with TyG-WC being a better indicator. TyG-BMI and TyG-WC could reliably predict liver fibrosis in this population. These indices appear to be simple, practical, and affordable tools for screening NAFLD and liver fibrosis in clinical settings.

摘要

甘油三酯-葡萄糖(TyG)指数已被提出作为非酒精性脂肪性肝病(NAFLD)的可靠替代标志物。此外,NAFLD 与肥胖密切相关。本研究旨在比较 TyG 指数及其相关参数(TyG-腰围[WC]和 TyG-体重指数[BMI]),包括 TyG 和肥胖标志物,在预测超重/肥胖且无糖尿病个体的 NAFLD 和肝纤维化中的作用。这是一项横断面研究,共纳入 184 名超重/肥胖者(96 名患有和 88 名不患有 NAFLD),年龄 30-65 岁。使用已建立的公式计算 TyG、TyG-BMI 和 TyG-WC。通过瞬时弹性成像(FibroScan)测定肝硬度测量值(LSM)和受控衰减参数(CAP)。在相关性分析中,CAP 和 LSM 与 WC、BMI、TyG、TyG-BMI 和 TyG-WC 显著相关。回归分析突出了 TyG-WC 作为 NAFLD 的显著预测因子,标准化优势比最高(2.25,<0.001);而纤维化与 TyG-BMI 相关性更强。在接受者操作特征(ROC)分析中,TyG-WC 对 NAFLD 的检测显示出最大的 ROC 曲线下面积(AUC)(0.693,95%置信区间[CI]:0.617-0.769)。然而,TyG-BMI 是肝纤维化的更好判别因子(AUC:0.635,95%CI:0.554-0.714)。TyG-WC 值为 876(灵敏度:81.3%,特异性:52.3%)和 TyG-BMI 值为 259(灵敏度:78.3%,特异性:51.3%)是预测 NAFLD 和肝纤维化的最佳截断值。结果强调了 TyG 及其相关指数与 NAFLD 的显著相关性,TyG-WC 是更好的指标。TyG-BMI 和 TyG-WC 可在该人群中可靠地预测肝纤维化。这些指数似乎是在临床环境中筛查 NAFLD 和肝纤维化的简单、实用和经济实惠的工具。

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