Wu Juntao, Lai Haohong, Yin Jiyuan, Zhu Shan, Yang Haidi, Hong Haiyu
Department of Otolaryngology, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, People's Republic of China.
Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Aug 31;18:3111-3123. doi: 10.2147/DMSO.S526411. eCollection 2025.
Obstructive sleep apnea (OSA) contributes to non-alcoholic fatty liver disease (NAFLD) via pathways involving insulin resistance (IR). The triglyceride-glucose (TyG) index, a widely used marker of IR, is associated with both OSA and NAFLD. However, the role of the TyG index in linking OSA to NAFLD remains underexplored.
This study analyzed data from two cross-sectional studies: 920 participants from the Fifth Affiliated Hospital of Sun Yat-sen University and 1,603 participants from NHANES 2005-2008. Mediation analysis assessed the TyG index's role in the OSA-NAFLD relationship. Weighted multivariable logistic regression and restricted cubic spline (RCS) regression explored the association between the TyG index and NAFLD in patients with OSA.
Mediation analysis showed the TyG index mediated the OSA-NAFLD association, accounting for 35.33% and 20.06% in Chinese and American participants, respectively (P < 0.001). Logistic regression revealed that higher TyG index values were significantly associated with increased NAFLD risk in patients with OSA, with ORs of 2.32 (95% CI: 1.78-3.07) for Chinese and 6.80 (95% CI: 4.42-10.45) for American participants (P < 0.001). RCS regression showed a linear increase in NAFLD risk with higher TyG index values in patients with OSA.
The TyG index significantly mediates the OSA-NAFLD relationship. Elevated TyG index values are significantly associated with NAFLD risk in patients with OSA. The TyG index is a biologically meaningful and effective biomarker of IR in the association between OSA and NAFLD, with potential for early identification of NAFLD in patients with OSA.
阻塞性睡眠呼吸暂停（OSA）通过涉及胰岛素抵抗（IR）的途径导致非酒精性脂肪性肝病（NAFLD）。甘油三酯-葡萄糖（TyG）指数是一种广泛使用的IR标志物，与OSA和NAFLD均相关。然而，TyG指数在将OSA与NAFLD联系起来的作用仍未得到充分研究。
本研究分析了两项横断面研究的数据：来自中山大学附属第五医院的920名参与者和来自2005 - 2008年美国国家健康与营养检查调查（NHANES）的1603名参与者。中介分析评估了TyG指数在OSA - NAFLD关系中的作用。加权多变量逻辑回归和受限立方样条（RCS）回归探讨了OSA患者中TyG指数与NAFLD之间的关联。
中介分析表明TyG指数介导了OSA - NAFLD的关联，在中国和美国参与者中分别占35.33%和20.06%（P < 0.001）。逻辑回归显示，较高的TyG指数值与OSA患者中NAFLD风险增加显著相关，中国参与者的比值比（OR）为2.32（95%置信区间：1.78 - 3.07），美国参与者为6.80（95%置信区间：4.42 - 10.45）（P < 0.001）。RCS回归显示，OSA患者中NAFLD风险随TyG指数值升高呈线性增加。
TyG指数显著介导了OSA - NAFLD关系。OSA患者中TyG指数值升高与NAFLD风险显著相关。TyG指数是OSA与NAFLD关联中IR的一个具有生物学意义且有效的生物标志物，具有早期识别OSA患者中NAFLD的潜力。
