Megalaa Magdy H, Zeid Ahmed, Zietoun Mohamed, Salem Dina M, Elrahmany Shimaa M
Diabetes, Metabolism, and Lipidology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Metab Syndr Relat Disord. 2025 Sep 16. doi: 10.1177/15578518251377780.
The triglyceride-glucose (TyG) index and related parameters have recently been advocated as efficient diagnostic markers for metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population. Yet, there is a paucity of data addressing their significance in MASLD diagnosis and severity assessment in the vulnerable population of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the predictive capacity of TyG-related indices for MASLD diagnosis in patients with T2DM, and to investigate the relationship of these parameters with hepatic steatosis severity. This cross-sectional study encompassed a cohort of 600 adults diagnosed with T2DM, who were enrolled from the diabetes and metabolism outpatient clinic at Alexandria Main University Hospital. After excluding secondary causes, hepatic steatosis was diagnosed using the FibroScan 430 mini+ machine (EchoSense, Paris, France), with results expressed as the controlled attenuation parameter. Anthropometric and biochemical measurements were utilized to derive TyG-related indices, including TyG index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist to height ratio (TyG-WHtR). MASLD was diagnosed in 83% of the recruited subjects. The studied TyG-related parameters were markedly higher in patients with severe steatosis. Moreover, multivariate analysis identified TyG-BMI as an independent risk factor for severe steatosis. Furthermore, the receiver operating characteristic curve was used to assess the diagnostic performance of the studied TyG indices for detecting MASLD in individuals with T2DM. The area under the curve for each of the four indicators was as follows: 0.775 for TyG-BMI, followed by 0.755 for TyG-WC, 0.741 for TyG-WHtR, and 0.637 for TyG index. These findings revealed good predictive capacity for all four parameters, especially TyG-BMI, which exhibited the highest level of predictive accuracy. The TyG index and related parameters, particularly TyG-BMI, are reliable and cost-effective biomarkers for detecting and assessing the severity of MASLD.
甘油三酯-葡萄糖（TyG）指数及相关参数最近被提倡作为普通人群中代谢功能障碍相关脂肪性肝病（MASLD）的有效诊断标志物。然而，在2型糖尿病（T2DM）这一弱势群体中，关于它们在MASLD诊断和严重程度评估中的意义的数据却很匮乏。本研究的目的是评估TyG相关指数对T2DM患者MASLD诊断的预测能力，并研究这些参数与肝脂肪变性严重程度的关系。这项横断面研究纳入了600名被诊断为T2DM的成年人队列，他们来自亚历山大主大学医院的糖尿病与代谢门诊。排除继发原因后，使用FibroScan 430 mini+机器（法国巴黎EchoSense公司）诊断肝脂肪变性，结果以受控衰减参数表示。利用人体测量和生化测量得出TyG相关指数，包括TyG指数、TyG体重指数（TyG-BMI）、TyG腰围（TyG-WC）和TyG腰高比（TyG-WHtR）。83%的入组受试者被诊断为MASLD。在严重脂肪变性患者中，所研究的TyG相关参数明显更高。此外，多变量分析确定TyG-BMI是严重脂肪变性的独立危险因素。此外，使用受试者工作特征曲线评估所研究的TyG指数对T2DM个体中MASLD的诊断性能。四个指标各自的曲线下面积如下：TyG-BMI为0.775，其次TyG-WC为0.755，TyG-WHtR为0.741，TyG指数为0.637。这些发现揭示了所有四个参数都具有良好的预测能力，尤其是TyG-BMI，其表现出最高水平的预测准确性。TyG指数及相关参数，特别是TyG-BMI，是检测和评估MASLD严重程度的可靠且具有成本效益的生物标志物。
