甘油三酯-葡萄糖相关指标与非酒精性脂肪性肝病或代谢相关脂肪性肝病患者死亡的相关性。

Association between triglyceride-glucose related indices and mortality among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease.

机构信息

Department of Infectious Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.

NHC (National Health Commission of the People's Republic of China) Key Laboratory of Tropical Disease Control, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570216, China.

出版信息

Cardiovasc Diabetol. 2024 Jul 4;23(1):232. doi: 10.1186/s12933-024-02343-7.

DOI:10.1186/s12933-024-02343-7

PMID:38965572

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11225330/

Abstract

BACKGROUND

The prognostic value of triglyceride-glucose (TyG) related indices in non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is still unclear. This study aimed to determine the associations between TyG-related indices and long-term mortality in this population.

METHODS

The data came from the National Health and Nutrition Examination Survey (NHANES III) and National Death Index (NDI). Baseline TyG, TyG combining with body mass index (TyG-BMI), and TyG combining with waist circumference (TyG-WC) indices were calculated, and mortality status was determined through 31 December 2019. Multivariate Cox and restricted cubic spline (RCS) regression models were performed to evaluate the relationship between TyG-related indices and long-term mortality among participants with NAFLD/MASLD. In addition, we examined the association between TyG-related indices and all-cause mortality within subgroups defined by age, sex, race/ethnicity, and fibrosis-4 index (FIB-4).

RESULTS

There were 10,390 participants with completed ultrasonography and laboratory data included in this study. NAFLD was diagnosed in 3672/10,390 (35.3%) participants, while MASLD in 3556/10,390 (34.2%) amongst the overall population. The multivariate Cox regression analyses showed high levels of TyG-related indices, particularly in TyG-BMI and TyG-WC indices were significantly associated with the all-cause mortality, cardiovascular mortality, and diabetes mortality in either NAFLD or MASLD. The RCS curves showed a nonlinear trend between three TyG-related indices with all-cause mortality in either NAFLD or MASLD. Subgroup analyses showed that TyG-BMI and TyG-WC indices were more suitable for predicting all-cause mortality in patients without advanced fibrosis.

CONCLUSION

Our study highlights the clinical value of TyG-related indices in predicting the survival of the NAFLD/MASLD population. TyG-BMI and TyG-WC indices would be the surrogate biomarkers for the follow-up of the population without advanced fibrosis.

摘要

背景

三酰甘油-葡萄糖（TyG）相关指数在非酒精性脂肪性肝病（NAFLD）或代谢相关脂肪性肝病（MASLD）中的预后价值尚不清楚。本研究旨在确定该人群中 TyG 相关指数与长期死亡率之间的关系。

方法

数据来自国家健康与营养调查（NHANES III）和国家死亡指数（NDI）。计算基线 TyG、TyG 与体重指数（TyG-BMI）结合以及 TyG 与腰围（TyG-WC）指数，并通过 2019 年 12 月 31 日确定死亡率状态。采用多变量 Cox 和限制性三次样条（RCS）回归模型评估 TyG 相关指数与 NAFLD/MASLD 患者长期死亡率之间的关系。此外，我们还在年龄、性别、种族/民族和纤维化 4 指数（FIB-4）定义的亚组内检查了 TyG 相关指数与全因死亡率之间的关系。

结果

本研究共纳入 10390 名完成超声和实验室数据的参与者。3672/10390（35.3%）名参与者诊断为 NAFLD，3556/10390（34.2%）名参与者诊断为 MASLD。多变量 Cox 回归分析显示，TyG 相关指数水平较高，尤其是 TyG-BMI 和 TyG-WC 指数，与 NAFLD 或 MASLD 患者的全因死亡率、心血管死亡率和糖尿病死亡率显著相关。RCS 曲线显示，在 NAFLD 或 MASLD 中，三个 TyG 相关指数与全因死亡率之间存在非线性趋势。亚组分析显示，TyG-BMI 和 TyG-WC 指数更适合预测无晚期纤维化患者的全因死亡率。