Zhou Tengchao, Xie Canbin
Department of Interventional Vascular Surgery, Hunan Provincial People's Hospital (The First-affiliated Hospital of Hunan Normal University), Jiefang West Road, Changsha, Hunan, 410000, P. R. China.
Sci Rep. 2025 May 23;15(1):18044. doi: 10.1038/s41598-025-03453-2.
Previous studies have demonstrated a strong correlation between the Triglyceride-Glucose Index(TyG) index and diabetes mellitus; however, limited research has focused on the relationship between the TyG index and the incidence of diabetes mellitus in the Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) population. This study aims to investigate the association between the TyG index and the occurrence of diabetes mellitus in the MASLD population in Japan. This retrospective cohort study included 2,741 patients with MASLD from Murakami Memorial Hospital in Japan, spanning the years 2004 to 2015. The primary method employed to investigate the relationship between the TyG index and the occurrence of diabetes was Cox proportional hazards regression. Additionally, a Generalized Additive Model and a two-piecewise linear regression model were utilized to assess whether a linear relationship exists between the TyG index and the development of diabetes, as well as to calculate threshold effects. After adjusting for variables that may potentially influence the occurrence of diabetes, we found that the TyG index was positively correlated with diabetes incidence (HR = 1.43, 95% CI: 1.03, 1.98) in MASLD population overall. Further in-depth analysis revealed a nonlinear relationship between the TyG index and the occurrence of diabetes. When the TyG index was less than 7.95, it exhibited a negative correlation (HR = 0.22, 95% CI: 0.07, 0.66); however, when the TyG index exceeded 7.95, it showed a positive correlation (HR = 1.68, 95% CI: 1.20, 2.36). Additionally, we conducted a subject working curve analysis on the TyG index and the two components used to calculate it, fasting blood glucose and triglycerides, and found that the TyG index demonstrated higher sensitivity and specificity in predicting the occurrence of diabetes in the MASLD population. TyG index exhibits a nonlinear relationship with the incidence of diabetes in the MASLD population, and its sensitivity and specificity are superior to those of fasting blood glucose and triglycerides.
以往研究表明甘油三酯-葡萄糖指数（TyG指数）与糖尿病之间存在很强的相关性；然而，针对TyG指数与代谢功能障碍相关脂肪性肝病（MASLD）人群中糖尿病发病率之间关系的研究有限。本研究旨在调查日本MASLD人群中TyG指数与糖尿病发生之间的关联。这项回顾性队列研究纳入了2004年至2015年间日本村上纪念医院的2741例MASLD患者。用于研究TyG指数与糖尿病发生之间关系的主要方法是Cox比例风险回归。此外，还使用广义相加模型和两段式线性回归模型来评估TyG指数与糖尿病发生之间是否存在线性关系，以及计算阈值效应。在对可能影响糖尿病发生的变量进行调整后，我们发现总体MASLD人群中TyG指数与糖尿病发病率呈正相关（HR = 1.43，95%CI：1.03，1.98）。进一步深入分析发现TyG指数与糖尿病发生之间存在非线性关系。当TyG指数小于7.95时，呈负相关（HR = 0.22，95%CI：0.07，0.66）；然而，当TyG指数超过7.95时，呈正相关（HR = 1.68，95%CI：1.20，2.36）。此外，我们对TyG指数及其用于计算的两个组成部分空腹血糖和甘油三酯进行了受试者工作曲线分析，发现TyG指数在预测MASLD人群中糖尿病发生方面表现出更高的敏感性和特异性。TyG指数在MASLD人群中与糖尿病发病率呈非线性关系，其敏感性和特异性优于空腹血糖和甘油三酯。
