The association of triglyceride-glucose-waist circumference with metabolic associated fatty liver disease and the severity of liver steatosis and fibrosis in American adults: a population-based study

Abstract

Background

The global obesity pandemic has led to an alarming rise in the prevalence of metabolic-associated fatty liver disease (MAFLD), making it a substantial clinical and economic burden on society. Early detection and effective treatment of MAFLD are imperative to mitigate its impact.

Methods

This cross-sectional study was conducted involving 4634 adults from the National Health and Nutrition Examination Surveys (NHANES) 2017–2018 cycle. Transient elastography (TE) was used to diagnose MAFLD and assess the extent of liver steatosis and fibrosis. Multivariate logistic regression models were utilized to examine the association between the triglyceride and glucose index-waist circumference (TyG-WC) and the risk of MAFLD, liver fibrosis, and steatosis.

Results

A positive association between TyG-WC and MAFLD persisted across all three models: model1: OR = 8.44, 95% CI: 6.85–10.38 (unadjusted), model2: OR = 8.28, 95% CI: 6.53–10.50 (partially adjusted), and model3: OR = 7.98, 95% CI: 4.11–15.46 (fully adjusted). Further investigation through interaction and stratified analysis revealed that this association was more pronounced in the non-obese and Non-Hispanic White persons groups. Moreover, a non-linear relationship analysis unveiled threshold and saturation effects between TyG-WC and MAFLD. Specifically, a TyG-WC value of approximately 600 may represent the threshold effect for MAFLD risk, while 1200 may signify the saturation effect of MAFLD risk. Finally, a robust correlation between TyG-WC and the severity of liver steatosis and fibrosis was found.

Conclusions

The findings suggest that the TyG-WC index exhibits excellent predictive value for MAFLD in the general American population.

Keywords:

• MAFLD
• TyG-WC
• steatosis
• fibrosis
• transient elastography
• insulin resistance

Acknowledgments

The data collection from NHANES was supported by the CDC.

Authors’ contributions

YLX, ZXW and WLK conceived and designed the study. ZXW, XYZ and SZB collected the data. KH, ZXW and JWL performed the statistical analyses and interpreted the data. ZXW, SZB, and KH drafted and revised the manuscript. YMS, WLK and YLX critically reviewed the manuscript. All authors have given their final approval for the publication of the manuscript.

Disclosure statement

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The research protocol for NHANES involving human participants was approved by the NCHS Research Ethics Review Board, and informed consent was obtained from all study participants. The informed consent procedures for all participants are publicly accessible on the CDC.gov website. Furthermore, all methods were performed following relevant guidelines and regulations.

Data availability statement

The analysis in this study utilized publicly available datasets, which can be accessed at the following link: https://www.cdc.gov/nchs/nhanes/.

Additional information

Funding

This work was supported by the Second Batch of Young Technical Backbone Talents Project of the Ningbo Municipal Health Commission (rc2022008), and the Natural Science Foundation of Ningbo(2021J262)