Chen Yuwei, Lin Xinjun, Chen Yanqiu, Wang Bingcai, Xu Chaoxiang, Wang Yaoguo
Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
Department of Ultrasound Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
Front Med (Lausanne). 2025 Aug 26;12:1626672. doi: 10.3389/fmed.2025.1626672. eCollection 2025.
Non-alcoholic fatty liver disease (NAFLD) affects over 25% of the global population and is associated with numerous comorbidities. Several indices, including the triglyceride-glucose (TyG) index, TyG-waist circumference (TyG-WC), TyG-body mass index (TyG-BMI), and TyG-waist-height ratio (TyG-WHtR), have been strongly associated with NAFLD. However, research on the stratification of hepatic steatosis severity in NAFLD, particularly in older adults, remains limited. This study aimed to investigate the relationship between TyG index and NAFLD in elderly individuals.
This study analyzed physical examination data from 3,954 individuals aged 60 years or older, collected during a 2-year follow-up period at Nan'an General Hospital, Nanqiao Branch. Binary logistic regression and receiver operating characteristic curve analyses were employed to examine the relationship between the TyG index and NAFLD and its various pathological stages. Additionally, the change in the TyG index during follow-up was calculated to assess its predictive significance for NAFLD progression.
The TyG, TyG-WC, TyG-BMI, and TyG-WHtR quartiles were grouped for analysis in patients with NAFLD, revealing significant differences in hepatic steatosis severity between the groups ( < 0.001). All four parameters were significant predictors of hepatic steatosis severity ( < 0.001). After further adjusting for age, sex, marital status, alcohol consumption, smoking status, exercise, hypertension, diabetes, coronary heart disease, uric acid, HDL, ALT, and AST, the odds ratios (ORs) for the fourth quartile were 4.36 (3.39-5.61), 19.77 (14.92-26.22), 28.23 (20.81-28.28), and 14.56 (11.05-19.19), with all values <0.001. The areas under the curve values for the four parameters for predicting NAFLD status were 0.744, 0.811, 0.840, and 0.813, respectively. Furthermore, an increase in the TyG index was identified as a risk factor for disease progression, while a decrease was associated with improvement in NAFLD severity.
The TyG index and its related parameters serve as reliable, non-invasive indicators for the diagnosis and progression of NAFLD in elderly populations. Monitoring changes in these indices can improve early detection and management of NAFLD.
非酒精性脂肪性肝病（NAFLD）影响着全球超过25%的人口，并与多种合并症相关。包括甘油三酯-葡萄糖（TyG）指数、TyG-腰围（TyG-WC）、TyG-体重指数（TyG-BMI）和TyG-腰高比（TyG-WHtR）在内的多个指标与NAFLD密切相关。然而，关于NAFLD患者肝脂肪变性严重程度分层的研究，尤其是在老年人中的研究，仍然有限。本研究旨在探讨TyG指数与老年个体NAFLD之间的关系。
本研究分析了在南桥分院南安总医院为期2年的随访期间收集的3954名60岁及以上个体的体格检查数据。采用二元逻辑回归和受试者工作特征曲线分析来研究TyG指数与NAFLD及其不同病理阶段之间的关系。此外，计算随访期间TyG指数的变化，以评估其对NAFLD进展的预测意义。
对NAFLD患者按TyG、TyG-WC、TyG-BMI和TyG-WHtR四分位数进行分组分析，结果显示各组之间肝脂肪变性严重程度存在显著差异（<0.001）。所有四个参数均为肝脂肪变性严重程度的显著预测因子（<0.001）。在进一步调整年龄、性别、婚姻状况、饮酒、吸烟状况、运动、高血压、糖尿病、冠心病、尿酸、高密度脂蛋白、谷丙转氨酶和谷草转氨酶后，第四四分位数的比值比（OR）分别为4.36（3.39 - 5.61）、19.77（14.92 - 26.22）、28.23（20.81 - 28.28）和14.56（11.05 - 19.19），所有P值均<0.001。这四个参数预测NAFLD状态的曲线下面积值分别为0.744、0.811、0.840和0.813。此外，TyG指数升高被确定为疾病进展的危险因素，而TyG指数降低与NAFLD严重程度改善相关。
TyG指数及其相关参数是老年人群NAFLD诊断和病情进展的可靠、无创指标。监测这些指标的变化可改善NAFLD的早期发现和管理。
