Non-Traditional Blood Lipid Indices for Metabolism Dysfunction-Associated Fatty Liver Disease Prediction in Non-Obese Type 2 Diabetes Mellitus

Figures & data

Table 1 Clinical Characteristics of the Patients

Variables	MAFLD (n=34)	Non-MAFLD (n=156)	P
Sex			0.002*
Male	24 (70.6%)	64 (41%)
Female	10 (29.4%)	92 (59%)
Age (years)	50 (46,60)	57 (46,64)	0.150
Drinking history	8 (23.5%)	17 (10.9%)	0.048*
Hypertension	1 (2.9%)	4 (2.6%)	0.451
Duration of diabetes			0.001*
<5 years	12 (35.3%)	90 (57.7%)
5–10 years	4 (11.8%)	34 (21.8%)
≥10 years	18 (52.9%)	32 (20.5%)
BMI (kg/m^2)	23.66 (22.28,23.78)	21.63 (21.22,23.44)	<0.001*
SBP (mmHg)	144 (128,149)	145 (127,150)	0.729
DBP (mmHg)	87 (81,90)	86 (80,90)	0.169
TC (mmol/L)	4.19 (3.75,5.59)	4.19 (3.37,5.78)	0.365
LDL-C (mmol/L)	3.81 (2.36,3.95)	2.79 (2.11,3.81)	0.034*
HDL-C (mmol/L)	0.72 (0.56,0.91)	1.01 (0.90,1.26)	<0.001*
TG (mmol/L)	1.63 (1.34,1.899)	1.34 (1.01,1.71)	0.001*
ALT (U/L)	40.7 (23.4,43.4)	35.6 (22.6,43.4)	0.180
AST (U/L)	28.1 (18.3,36.4)	21.4 (15.5,34.1)	0.031*
HCY (µmol/L)	15.7 (10.9,16.7)	14.7 (12.1,16.7)	0.547
ALB (g/L)	43.0 (38.0,46.3)	38.0 (37.3,43.9)	0.583
FBG (mmol/L)	8.04 (7.71,9.62)	8.31 (5.71,9.97)	0.615
HbA1c (%)	8.5 (6.2,10.8)	7.7 (6.4,10.6)	0.679
Cr (µmol/L)	62.0 (48.0,63.0)	56.1 (38.0,65.2)	0.247
ALP (U/L)	141.0 (82.4,158.0)	73.7 (56.0,98.6)	<0.001*
Lip-α (mg/L)	113.1 (78.8,377.5)	125.5 (75.5,366.4)	0.912
BUA (µmol/L)	378.0 (349.9,404.6)	288.8 (238.2,369.0)	<0.001*
TyG	9.36 (9.08,9.52)	8.99 (8.52,9.38)	<0.001*
TyG*BMI	212.551 (202.356,225.156)	203.00 (180.248,211.570)	0.002*
TyG/HDL-C	12.614 (10.193,16.7141)	9.311 (7.135,10.6495)	<0.001*
LDL-C/HDL-C	3.959 (3.405,5.676)	2.936 (2.344,3.619)	<0.001*

Notes: Data are shown as n (%) or median (range). *P<0.05 was considered statistically significant.

Abbreviations: MAFLD, metabolism dysfunction-associated fatty liver disease; SBP, systolic blood pressure; DBP, diastolic blood pressure; BMI, body mass index; FBG, fasting plasma glucose; HbA1c, glycated hemoglobin; TG, total triglyceride; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; ALT, alanine transaminase; AST, aspartate aminotransferase; HCY, homocysteine; Cr, creatinine; ALP, alkaline phosphatase; Lip-α, lipoprotein-α; BUA, blood uric acid; ALB, albumin; TyG, triacylglycerol-glucose index.

Figure 1 Flowchart of Patients.

Table 2 The Multivariable Logistic Regression of MAFLD

Variables	OR	95% CI	P
Sex	0.374	0.020–6.893	0.508
Drinking history	0.744	0.054–10.253	0.825
Duration of diabetes	0.552	0.113–2.283	0.412
TG	0.280	0.057–1.374	0.117
ALP	0.994	0.996–1.004	0.932
AST	1.216	1.059–1.374	0.006*
BUA	1.017	1.002–1.032	0.022*
TyG*BMI	1.231	1.051–1.442	0.010*
TyG/HDL-C	3.162	1.228–8.141	0.017*
LDL-C/HDL-C	1.445	0.421–4.954	0.558

Note: *P<0.05 was considered statistically significant.

Abbreviations: MAFLD, metabolism dysfunction-associated fatty liver disease; OR, odds ratio; CI, confidence interval; TG, total triglyceride; ALP, alkaline phosphatase; AST, aspartate aminotransferase; BUA, blood uric acid; TyG, triacylglycerol-glucose index; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 3 Predictive Values of the TyG*BMI and TyG/HDL-C

Parameters	Area Under the ROC Curve	95% CI		P	Cutoff value	Sensitivity (%)	Specificity (%)
TyG*BMI	0.812	0.744	0.880	<0.001*	210.943	91.2	69.2
TyG/HDL-C	0.929	0.884	0.973	<0.001*	10.607	85.3	88.5

Note: *P<0.05 was considered statistically significant.

Abbreviations: ROC, received operating characteristics; CI, confidence interval; TyG, triacylglycerol-glucose index; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol.

Figure 2 Receiver-Operating Characteristics (ROC) Curve of Each Parameter for Predicting Metabolic Dysfunction-Associated Fatty Liver Disease.

Table 4 The Multivariable Logistic Regression of MAFLD in Female Patients

Variables	OR	95% CI	P
Drinking history	0.000	0.000–1.000	0.999
Duration of diabetes	0.331	0.040–2.772	0.308
TG	0.170	0.003–9.076	0.382
ALP	0.998	0.985–1.011	0.728
AST	1.401	0.965–2.035	0.077
BUA	1.029	1.006–1.052	0.015*
TyG*BMI	1.499	0.979–2.146	0.064
TyG/HDL-C	6.129	1.011–7.135	0.049*
LDL-C/HDL-C	0.74	0.155–3.525	0.706

Note: *P<0.05 was considered statistically significant.

Abbreviations: MAFLD, metabolism dysfunction-associated fatty liver disease; OR, odds ratio; CI, confidence interval; TG, total triglyceride; ALP, alkaline phosphatase; AST, aspartate aminotransferase; BUA, blood uric acid; TyG, triacylglycerol-glucose index; BMI, body mass index; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 5 Predictive Values of the TyG/HDL-C

Parameters	Area Under the ROC Curve	95% CI		P	Cutoff value	Sensitivity (%)	Specificity (%)
TyG/HDL-C	0.892	0.784	1.000	<0.000*	10.151	87.5	78.5

Note: *P<0.05 was considered statistically significant.

Abbreviations: TyG, triacylglycerol-glucose index; HDL-C, high-density lipoprotein cholesterol.

Figure 3 Gender Subgroup Analysis: ROC Curves for Parameters Predictive of Metabolic Dysfunction-Associated Fatty Liver Disease in Female Patients.