Baseline level and change trajectory of the triglyceride-glucose index in relation to the development of NAFLD: a large population-based cohort study

Yaqin Wang; Jiangang Wang; Lei Liu; Pingting Yang; Shuwen Deng; Xuelian Liu; Linlin Zhao; Changfa Wang; Ying Li

doi:10.3389/fendo.2023.1137098

Baseline level and change trajectory of the triglyceride-glucose index in relation to the development of NAFLD: a large population-based cohort study

Front Endocrinol (Lausanne). 2023 May 8:14:1137098. doi: 10.3389/fendo.2023.1137098. eCollection 2023.

Authors

Yaqin Wang¹, Jiangang Wang¹, Lei Liu¹, Pingting Yang¹, Shuwen Deng¹, Xuelian Liu¹, Linlin Zhao¹, Changfa Wang², Ying Li¹

Affiliations

¹ Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
² General Surgery Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

Abstract

Background: Insulin resistance (IR) and nonalcoholic fatty liver disease (NAFLD) are closely related. The triglyceride-glucose index (TyG index) has been proposed as a new indicator of IR. It remains unclear whether the triglyceride-glucose (TyG) index is prospectively associated with incident nonalcoholic fatty liver disease (NAFLD).

Methods: This large-scale study comprised 1 prospective cohort totaling 22,758 subjects without NAFLD at baseline who underwent repeated health examinations and 1 subcohort totaling 7,722 subjects with more than three visits. The TyG index was ascertained mathematically by ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). NAFLD was diagnosed by ultrasound without other concomitant liver diseases. A combinatorial Cox proportional hazard model and latent class growth mixture modeling method were used to identify the association of the TyG index and its transition trajectories with NAFLD risk.

Results: During 53,481 person-years of follow-up, there were 5319 incident cases with NAFLD. Compared with those in the lowest quartile of the baseline TyG index, participants in the highest quartile had 2.52-fold (95% confidence interval, 2.21-2.86) higher odds of incident NAFLD. Similarly, restricted cubic spline analysis showed a dose-response relationship (p nonlinearity<0.001). Subgroup analyses showed a more significant association in the female and normal body size populations (p for interaction<0.001). Three distinct trajectories of changes in the TyG index were identified. Compared with the continued low group, the moderately increasing and highly increasing groups conferred 1.91-fold (1.65-2.21) and 2.19-fold (1.73-2.77) higher NAFLD risk, respectively.

Conclusions: Participants with a higher baseline TyG index or a higher excessive TyG exposure were associated with an increased NAFLD risk. The findings imply that lifestyle interventions and modulation of IR might be considered to both reduce TyG index levels and prevent NAFLD development.

Keywords: cohort study; insulin resistance; non-alcoholic fatty liver disease; risk factors; triglyceride glucose index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Female
Glucose
Humans
Insulin Resistance*
Non-alcoholic Fatty Liver Disease* / epidemiology
Prospective Studies
Triglycerides

Substances

Glucose
Triglycerides

Grants and funding

This research was supported by grants from the National Key R&D Program of China (No. 2021YFC2500500), Changsha Natural Science Foundation (No. kq2208351), Hunan Provincial Natural Science Foundation (No. 2020JJ4854 and 2021JJ40934), National Science Foundation of China (No.81973324) and a Hunan Young Talent grant (No.2020RC3063).