美国代谢相关脂肪性肝病成人患者甘油三酯-葡萄糖指数与肝纤维化的关联：一项基于2017-2020年美国国家健康与营养检查调查（NHANES）的横断面研究
Association between the triglyceride-glucose index and liver fibrosis in adults with metabolism-related fatty liver disease in the United States: a cross-sectional study of NHANES 2017-2020.
作者信息
Ying Yuou, Ji Yuan, Ju Ruyi, Chen Jinhan, Chen Mingxian
机构信息
The Second Affiliated College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
出版信息
BMC Gastroenterol. 2025 Jan 2;25(1):3. doi: 10.1186/s12876-024-03579-z.
OBJECTIVE
This study aimed to examine the association between the triglyceride-glucose (TyG) index and liver fibrosis (LF) in U.S. adults with Metabolic Dysfunction-Associated Steatotic Liver Disease (MAFLD).
METHODS
Using data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) database, we conducted a population-based cross-sectional study with 1,324 participants. MAFLD was defined as a controlled attenuation parameter (CAP) score ≥ 248 dB/m accompanied by metabolic dysfunction. A median liver stiffness measurement ≥ 8.2 kPa was used to identify significant fibrosis (≥ F2). Multivariable logistic regression was employed to assess the impact of the TyG index on LF outcomes. A restricted cubic spline (RCS) model was used to explore nonlinear effects, and receiver operating characteristic (ROC) curves were applied to evaluate the effectiveness in predicting.
RESULTS
Among the participants, 716 were men and 608 were women, aged 20 to 80 years, representing various racial groups. Significant fibrosis was observed in 137 out of 1,324 participants. After adjusting for confounding factors, a higher TyG index was significantly associated with an increased incidence of MAFLD-related LF (OR = 2.18, 95% CI, 1.14-4.18; p < 0.05). Elevated TyG levels showed a positive correlation with significant fibrosis, with an odds ratio (OR) exceeding 1 when the TyG index was above 8.054. Subgroup analyses stratified by sex, age, and body mass index (BMI) revealed differences after adjusting for confounders. The association was stronger in women (OR = 2.53, 95% CI, 1.16-5.53) than in men (OR = 1.95, 95% CI, 0.81-4.72). A significant correlation was also found between TyG levels and obesity status (overweight: OR = 4.80, 95% CI, 1.27-18.2; obese: OR = 2.26, 95% CI, 1.20-5.53). In MAFLD patients aged 40-59, TyG was strongly associated with LF (OR = 2.85, 95% CI, 1.16-6.79). Furthermore, the area under the ROC curve (AUC) for the TyG index in predicting significant fibrosis in MAFLD patients was 0.73 (95% CI, 0.68-0.78), indicating moderate predictive ability.
CONCLUSIONS
In the general U.S. population, elevated TyG index levels were positively associated with an increased risk of LF in MAFLD patients.
目的
本研究旨在探讨美国患有代谢功能障碍相关脂肪性肝病（MAFLD）的成年人中，甘油三酯-葡萄糖（TyG）指数与肝纤维化（LF）之间的关联。
方法
利用2017年至2020年国家健康与营养检查调查（NHANES）数据库中的数据，我们对1324名参与者进行了一项基于人群的横断面研究。MAFLD被定义为受控衰减参数（CAP）评分≥248 dB/m并伴有代谢功能障碍。采用肝脏硬度测量值中位数≥8.2 kPa来确定显著纤维化（≥F2）。使用多变量逻辑回归评估TyG指数对LF结局的影响。采用受限立方样条（RCS）模型探索非线性效应，并应用受试者工作特征（ROC）曲线评估预测有效性。
结果
参与者中，有716名男性和608名女性，年龄在20至80岁之间，代表了不同种族群体。1324名参与者中有137名观察到显著纤维化。在调整混杂因素后，较高的TyG指数与MAFLD相关LF的发病率增加显著相关（比值比[OR]=2.18，95%置信区间[CI]，1.14 - 4.18；p<0.05）。TyG水平升高与显著纤维化呈正相关，当TyG指数高于8.054时，比值比（OR）超过1。按性别、年龄和体重指数（BMI）分层的亚组分析在调整混杂因素后显示出差异。该关联在女性中（OR = 2.53，95% CI，1.16 - 5.53）比男性中（OR = 1.95，95% CI，0.81 - 4.72）更强。还发现TyG水平与肥胖状态之间存在显著相关性（超重：OR = 4.80，95% CI，1.27 - 18.2；肥胖：OR = 2.26，95% CI，1.20 - 5.53）。在40至59岁的MAFLD患者中，TyG与LF密切相关（OR = 2.85，95% CI，1.16 - 6.79）。此外，TyG指数预测MAFLD患者显著纤维化的受试者工作特征曲线下面积（AUC）为0.73（95% CI，0.68 - 0.78），表明具有中等预测能力。
结论
在美国普通人群中，TyG指数升高与MAFLD患者发生LF的风险增加呈正相关。
Zotero 插件