Beran Azizullah, Ayesh Hazem, Mhanna Mohammed, Wahood Waseem, Ghazaleh Sami, Abuhelwa Ziad, Sayeh Wasef, Aladamat Nameer, Musallam Rami, Matar Reem, Malhas Saif-Eddin, Assaly Ragheb
Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA.
Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 33314, USA.
J Clin Med. 2022 May 9;11(9):2666. doi: 10.3390/jcm11092666.
Insulin resistance (IR) is a major contributor to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The triglyceride-glucose (TyG) index has recently gained popularity for the assessment of IR and NAFLD due to its ease of acquisition and calculation. Therefore, we conducted this systematic review and meta-analysis to summarize the existing studies in the literature and provide a quantitative assessment of the significance of the TyG index in predicting the incidence of NAFLD. A comprehensive literature search in PubMed, EMBASE, and Web of Science databases from inception until 25 March 2022 was conducted. Published observational studies that evaluated the association between TyG index and NAFLD among the adult population and reported the hazard ratio (HR) or odds ratio (OR) for this association after multivariate analysis were included. The random-effects model was used as the primary statistical analysis model in the estimation of pooled ORs and HRs with the corresponding confidence intervals (CIs). A total of 17 observational studies, including 121,975 participants, were included. For studies analyzing the TyG index as a categorical variable, both pooled OR (6.00, CI 4.12-8.74) and HR (1.70, CI 1.28-2.27) were significant for the association between TyG index and incident NAFLD. For studies analyzing the TyG index as a continuous variable, pooled OR (2.25, CI 1.66-3.04) showed similar results. Consistent results were obtained in subgroup analyses according to the study design, sample size, ethnicity, and diabetic status. In conclusion, our meta-analysis demonstrates that a higher TyG index is associated with higher odds of NAFLD. TyG index may serve as an independent predictive tool to screen patients at high risk of NAFLD in clinical practice, especially in primary care settings. Patients with a high TyG index should be referred for a liver ultrasound and start intense lifestyle modifications. However, further large-scale prospective cohort studies are necessary to validate our findings.
胰岛素抵抗（IR）是非酒精性脂肪性肝病（NAFLD）发病机制的主要促成因素。甘油三酯-葡萄糖（TyG）指数因其易于获取和计算，最近在评估IR和NAFLD方面受到欢迎。因此，我们进行了这项系统评价和荟萃分析，以总结文献中的现有研究，并对TyG指数在预测NAFLD发病率中的意义进行定量评估。对PubMed、EMBASE和Web of Science数据库从建库至2022年3月25日进行了全面的文献检索。纳入已发表的观察性研究，这些研究评估了成年人群中TyG指数与NAFLD之间的关联，并在多变量分析后报告了该关联的风险比（HR）或优势比（OR）。在估计合并的OR和HR及其相应的置信区间（CI）时，随机效应模型用作主要的统计分析模型。共纳入17项观察性研究，包括121,975名参与者。对于将TyG指数作为分类变量进行分析的研究，TyG指数与新发NAFLD之间的关联，合并OR（6.00，CI 4.12 - 8.74）和HR（1.70，CI 1.28 - 2.27）均具有显著性。对于将TyG指数作为连续变量进行分析的研究，合并OR（2.25，CI 1.66 - 3.04）显示出类似结果。根据研究设计、样本量、种族和糖尿病状态进行的亚组分析获得了一致的结果。总之，我们的荟萃分析表明，较高的TyG指数与患NAFLD的较高几率相关。TyG指数可作为一种独立的预测工具，在临床实践中，尤其是在初级保健环境中，筛查NAFLD高危患者。TyG指数高的患者应转诊进行肝脏超声检查，并开始积极的生活方式改变。然而，需要进一步的大规模前瞻性队列研究来验证我们的发现。
