Association Between Triglyceride-Glucose Index and Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Cohort Study

Abstract

Objective

Insulin resistance (IR) is a major factor involved in the pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD). Triglyceride-glucose (TyG) index, an easily detected surrogate marker of IR, has not been explored sufficiently on its relationship with incident MAFLD risk. This study sought to investigate the association of baseline TyG index with the risk of MAFLD in a Chinese cohort.

Methods

This health check-up cohort was constructed with eligible 2056 Chinese from a community. The TyG index was calculated as ln (fasting triglyceride [mg/dL]×fasting glucose [mg/dL]/2). Cox proportion hazard models were used to evaluate the longitudinal association between baseline TyG index and the risk of MAFLD.

Results

During an average follow-up of 2.5 ± 0.5 years, about 12.8% of the subjects developed MAFLD, and the incidence of MAFLD trended to increase with the quartile TyG index (P_trend < 0.05). After adjusting for all confounders, TyG index was independently correlated with the risk of incident MAFLD (HR = 1.784, 95% CI = 1.383–2.302, P < 0.001), and the risk of MAFLD in the highest quartile of TyG index was two times higher than that in the lowest quartile (95% CI = 1.377–2.992, P = 0.001). The restricted cubic spline analysis showed that the relationship between TyG index and the risk of MAFLD was linear in males (P for total < 0.001; P for non-linearity = 0.746), but nonlinear in females (P for non-linearity = 0.040).

Conclusion

A high baseline TyG index was independently associated with a high risk of incident MAFLD, and we might develop the strategy of MAFLD prevention based on the TyG index.

Keywords:

• triglyceride-glucose index
• metabolic dysfunction-associated fatty liver disease
• insulin resistance
• risk
• cohort study

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Statement of Ethics

This study was approved by the Ethics Committee of Nanjing Medical University (NO. (2019) 740). Written informed consent was obtained from all participants.

Acknowledgments

Thank you Mr. Yongke Cao for providing article polishing support.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Six Talent Peaks Project in Jiangsu Province, China (2019, WSN-049), Natural Science Foundation of Jiangsu Province, China (BK20181369), Priority Academic Program Development of Jiangsu Higher Education Institutions (Nursing Science, 2018, No.87), Research and Innovation Team Project of School of Nursing, Nanjing Medical University, Graduate research and innovation projects in Jiangsu Province, China (KYCX21_1553), Jiangsu Province “333 High-level Personnel Training Programme” Project, and Joint Project of Health Commission of Shanghai Pudong District (PW2019D-11).