The Metabolic Score for Insulin Resistance Index is Superior to the Triglyceride and Glucose Index in Identifying Nonalcoholic Fatty Liver Disease in Hyperuricemia Subjects

Figures & data

Figure 1 Missing values of variables.

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; WBC, white blood cell count; NEU, neutrophil count; EOS, eosinophil count; BASO, basophil count; LYC, lymphocyte count; RBC, red blood cell count; HB, hemoglobin; RDW, red blood cell distribution width; MCV, mean red blood cell volume; PLT, platelet count; PDW, platelet distribution width; MPV, mean platelet volume; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBil, total bilirubin; DBil, direct bilirubin; IBil, indirect bilirubin; TP, total protein; ALB, albumin; GLB, globulin; GGT, gamma-glutamyl transpeptidase; TBA, total bile acids; BUN, blood urea nitrogen; Scr, serum creatinine; SUA, serum uric acid; FBG, fasting blood glucose; TC, total cholesterol; TG, triglycerides; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Apo-A1, apolipoprotein -A1; Apo-B, apolipoprotein-B; NAFLD, nonalcoholic fatty liver disease.

Figure 2 Flowchart of the participants.

Abbreviations: HUA, hyperuricemia; ROC, the receiver operating characteristic; TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance; NAFLD, nonalcoholic fatty liver disease.

Table 1 Univariate Analysis of NAFLD in the HUA Population

	Non-NAFLD	NAFLD	P
N	2370	3167
Sex (Female), %	483 (20.40)	571 (18.00)	0.03
Age, years	43.00 (29.00, 60.00)	50.00 (35.00, 62.00)	<0.001
BMI, kg/m^2	23.05 (21.30, 24.91)	26.22 (24.43, 28.35)	<0.001
SBP, mmHg	128.00 (119.00, 138.00)	134.00 (125.00, 144.00)	<0.001
DBP, mmHg	77.65 (10.69)	82.02 (10.63)	<0.001
HR, times/min	79.00 (71.00, 88.00)	80.00 (72.00, 88.00)	0.032
WBC, ×10^9/L	5.90 (5.10, 6.90)	6.50 (5.60, 7.50)	<0.001
NEU, ×10^9/L	3.30 (2.70, 4.00)	3.70 (3.00, 4.40)	<0.001
EOS, ×10^9/L	0.11 (0.07, 0.19)	0.13 (0.08, 0.21)	<0.001
BASO, ×10^9/L	0.02 (0.01, 0.03)	0.02 (0.02, 0.03)	<0.001
LYC,×10^9/L	2.00 (1.60, 2.40)	2.20 (1.80, 2.60)	<0.001
RBC, ×10^12/L	5.03 (0.52)	5.14 (0.49)	<0.001
HB, g/L	152.00 (143.00, 161.00)	155.00 (146.00, 163.00)	<0.001
RDW, %	12.50 (12.20, 13.00)	12.60 (12.20, 13.00)	<0.001
MCV, fl	91.60 (89.00, 94.00)	91.00 (88.00, 94.00)	<0.001
PLT, ×10^9/L	229.00 (194.00, 267.00)	238.00 (201.00, 279.00)	<0.001
PDW, %	13.30 (12.10, 15.00)	13.30 (12.10, 14.90)	0.439
MPV, fl	11.05 (1.01)	11.01 (0.98)	0.126
ALT, U/L	19.00 (15.00, 26.00)	31.00 (22.00, 48.00)	<0.001
AST, U/L	22.00 (19.00, 27.00)	26.00 (22.00, 33.00)	<0.001
TBil, µmol/L	13.90 (10.90, 18.10)	13.70 (10.70, 17.60)	0.021
DBil, µmol/L	3.20 (2.60, 4.30)	3.00 (2.40, 3.90)	<0.001
IBil, µmol/L	10.70 (8.10, 13.90)	10.60 (8.00, 13.80)	0.433
TP, g/L	75.00 (3.91)	76.10 (4.03)	<0.001
ALB, g/L	46.04 (2.52)	46.09 (2.23)	0.422
GLB, g/L	28.80 (26.60, 31.10)	29.70 (27.50, 32.20)	<0.001
GGT, U/L	23.00 (17.00, 33.00)	36.00 (25.00, 56.00)	<0.001
TBA, µmol/L	2.66 (1.82, 3.99)	2.90 (2.03, 4.39)	<0.001
BUN, mmol/L	5.00 (4.29, 5.90)	5.04 (4.33, 5.86)	0.636
Scr, µmol/L	77.00 (69.00, 85.00)	76.00 (68.00, 84.00)	<0.001
SUA, µmol/L	450.00 (427.00, 484.00)	463.00 (432.00, 505.00)	<0.001
FBG, mmol/L	5.22 (4.92, 5.58)	5.45 (5.08, 5.89)	<0.001
TC, mmol/L	5.12 (0.99)	5.41 (1.03)	<0.001
TG, mmol/L	1.27 (0.93, 1.74)	1.91 (1.37, 2.70)	<0.001
HDL, mmol/L	1.16 (0.99, 1.41)	1.00 (0.87, 1.18)	<0.001
LDL, mmol/L	3.00 (0.78)	3.20 (0.81)	<0.001
Apo-A1, g/L	1.36 (1.22, 1.53)	1.32 (1.19, 1.46)	<0.001
Apo-B, g/L	0.96 (0.25)	1.08 (0.26)	<0.001
TyG	8.61 (0.51)	9.06 (0.52)	<0.001
METS-IR	35.11 (5.72)	43.19 (6.87)	<0.001

Note: P-values less than 0.05 were bolded.

Abbreviations: NAFLD, nonalcoholic fatty liver disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; WBC, white blood cell count; NEU, neutrophil count; EOS, eosinophil count; BASO, basophil count; LYC, lymphocyte count; RBC, red blood cell count; HB, hemoglobin; RDW, red blood cell distribution width; MCV, mean red blood cell volume; PLT, platelet count; PDW, platelet distribution width; MPV, mean platelet volume; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBil, total bilirubin; DBil, direct bilirubin; IBil, indirect bilirubin; TP, total protein; ALB, albumin; GLB, globulin; GGT, gamma-glutamyl transpeptidase; TBA, total bile acids; BUN, blood urea nitrogen; Scr, serum creatinine; SUA, serum uric acid; FBG, fasting blood glucose; TC, total cholesterol; TG, triglycerides; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Apo-A1, apolipoprotein -A1; Apo-B, apolipoprotein-B; TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance.

Table 2 Multivariable Logistic Regression Analysis

	P	OR	95% CI
Age (Per 10 years)	<0.001	1.48	1.39, 1.58
DBP (Per 10 mmHg)	0.008	1.10	1.03, 1.19
HR, times/min	0.038	0.94	0.88, 1.00
EOS, ×10^9/L	0.109	0.56	0.27, 1.14
BASO, ×10^9/L	0.045	1.06	1.00, 1.13
HB, g/L	0.181	1.00	1.00, 1.01
MCV, fl	0.041	0.98	0.97, 1.00
PLT, ×10^9/L	0.022	1.00	1.00, 1.00
ALT, U/L	<0.001	1.06	1.05, 1.07
AST, U/L	<0.001	0.96	0.94, 0.97
TP, g/L	<0.001	1.11	1.06, 1.15
GLB, g/L	<0.001	0.92	0.88, 0.96
GGT, U/L	<0.001	1.01	1.00, 1.01
Scr, µmol/L	<0.001	0.98	0.98, 0.99
SUA, µmol/L	0.188	1.00	1.00, 1.00
HDL, mmol/L	<0.001	2.38	1.72, 3.29
TG, mmol/L	<0.001	0.65	0.53, 0.79
Apo-B, g/L	0.009	1.50	1.10, 2.04
TyG	<0.001	2.28	1.53, 3.43
METS-IR	<0.001	1.24	1.22, 1.27

Note: P-values less than 0.05 were bolded.

Abbreviations: DBP, diastolic blood pressure; HR, heart rate; EOS, eosinophil count; BASO, basophil count; HB, hemoglobin; MCV, mean red blood cell volume; PLT, platelet count; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TP, total protein; GLB, globulin; GGT, gamma-glutamyl transpeptidase; Scr, serum creatinine; SUA, serum uric acid; HDL, high-density lipoprotein; TG, triglycerides; Apo-B, apolipoprotein-B; TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance.

Figure 3 Association of independent risk factors.

Notes: The color determines the sign of the coefficient, where the red color represents a positive effect and the blue color indicates a negative one. The intensity of the color increases proportionally to the magnitude of the correlation coefficient among the genes. The values of the correlation coefficients are shown in the lower left corner. *P < 0.05, **P < 0.001.

Abbreviations: GLB, globulin; DBP, diastolic blood pressure; TP, total protein; Apo-B, apolipoprotein-B; TyG, triglyceride-glucose; AST, aspartate aminotransferase; TG, triglycerides; HR, heart rate; METS-IR, metabolic score for insulin resistance; ALT, alanine aminotransferase; PLT, platelet count; EOS, eosinophil count; BASO, basophil count; SUA, serum uric acid; HB, hemoglobin; Scr, serum creatinine; HDL, high-density lipoprotein; MCV, mean red blood cell volume.

Figure 4 Dose–response association between the TyG index (A), the METS-IR index (B) and the risk of NAFLD with HUA modeled by using RCS.

Abbreviations: TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance; NAFLD, nonalcoholic fatty liver disease; HUA, hyperuricemia.

Table 3 Youden Index and Other Evaluation Measures of AUC

	TyG	METS-IR
Se (95% CI)	0.630 (0.613~0.647)	0.834 (0.821~0.847)
Sp (95% CI)	0 0.723 (0.705~0.741)	0.641 (0.622~0.661)
PLR (95% CI)	2.272 (2.118~2.438)	2.326 (2.199~2.460)
NLR (95% CI)	0.512 (0.486~0.539)	0.258 (0.238~0.281)
ACC	0.67	0.752
Youden	8.87	36.904

Abbreviations: TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance; Se, sensitivity; Sp, specificity; PLR, positive likelihood ratio; NLR, negative likelihood ratio; ACC, accuracy; Youden, Youden index.

Figure 5 The ROC curves of the TyG index (A) and the METS-IR index (B) for prediction of NAFLD with HUA.

Abbreviations: TyG, triglyceride-glucose; METS-IR, metabolic score for insulin resistance; NAFLD, nonalcoholic fatty liver disease; HUA, hyperuricemia.