Song Seungah, Son Da-Hye, Baik Su-Jung, Cho Wan-Je, Lee Yong-Jae
Department of Family Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Healthcare Research Team, Health Promotion Center, Gangnam Severance Hospital, Seoul 06273, Korea.
Biomedicines. 2022 Sep 11;10(9):2251. doi: 10.3390/biomedicines10092251.
The triglyceride and glucose index (TyG index), a marker of insulin resistance, is positively associated with NAFLD. Modified TyG indices, combining body composition markers including body-mass index (BMI) or waist circumference (WC) with the TyG index, are reported to enhance predictability of insulin resistance. This study aimed to compare the usefulness of modified TyG indices for predicting NAFLD with the TyG index and fatty liver index (FLI). This cross-sectional study included 12,757 Korean adults. The TyG index and FLI were calculated using established formulas, and TyG-BMI and TyG-WC were calculated as TyG × BMI and TyG × WC, respectively. All measures were divided into quartiles. NAFLD severity (grade 0-3) was compared using ANOVA by quartiles of each index. Odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were calculated using a multiple logistic regression analysis. ROC and AUROC analyses were performed to compare the predictability of NAFLD using WC, BMI, TyG, TyG-BMI, TyG-WC, and FLI. A higher TyG index, TyG-BMI, TyG-WC, and FLI were associated with a higher grade of NAFLD. ORs (CIs) for NAFLD increased in all indices, especially in TyG-WC (39.251 (31.304-49.215)) and FLI (38.937 (31.145-48.678)). AUROC was 0.848 (0.840-0.855) for TyG-WC and 0.850 (0.842-0.857) for FLI. TyG-WC is a reliable indicator for the presence of NAFLD in Korean adults.
甘油三酯与葡萄糖指数（TyG指数）是胰岛素抵抗的一个标志物，与非酒精性脂肪性肝病呈正相关。据报道，将包括体重指数（BMI）或腰围（WC）在内的身体成分标志物与TyG指数相结合的改良TyG指数可提高胰岛素抵抗的预测能力。本研究旨在比较改良TyG指数与TyG指数及脂肪肝指数（FLI）在预测非酒精性脂肪性肝病方面的效用。这项横断面研究纳入了12757名韩国成年人。TyG指数和FLI使用既定公式计算，TyG-BMI和TyG-WC分别计算为TyG×BMI和TyG×WC。所有测量值均分为四分位数。使用方差分析按各指数的四分位数比较非酒精性脂肪性肝病严重程度（0-3级）。使用多因素逻辑回归分析计算非酒精性脂肪性肝病的比值比（OR）和95%置信区间（CI）。进行ROC和AUROC分析以比较使用WC、BMI、TyG、TyG-BMI、TyG-WC和FLI预测非酒精性脂肪性肝病的能力。较高的TyG指数、TyG-BMI、TyG-WC和FLI与更高等级的非酒精性脂肪性肝病相关。所有指数中，非酒精性脂肪性肝病的OR（CI）均升高，尤其是TyG-WC（39.251（31.304-49.215））和FLI（38.937（31.145-48.678））。TyG-WC的AUROC为0.848（0.840-0.855），FLI的AUROC为0.850（0.842-0.857）。TyG-WC是韩国成年人非酒精性脂肪性肝病存在情况的可靠指标。
