Endocrine

Triglyceride glucose index as a predictor for non-alcoholic fatty liver disease: insights from a longitudinal analysis in non-obese individuals

Nonalcoholic fatty liver disease (NAFLD), which was recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), is often associated with obesity. However, a substantial proportion of individuals with MASLD are not obese, making early detection challenging.

A recent study used the TyG index – a marker of insulin resistance calculated from fasting triglyceride and glucose levels – to predict the onset of MASLD in more than 16,000 participants without obesity.

The participants were divided into quartiles based on their TyG index, and the incidence of new-onset MASLD was tracked over five years.

Key findings:

•  A higher TyG index was strongly associated with an increased risk of developing MASLD, even after adjusting for age, sex, BMI, and lipid levels.
• Participants in the highest TyG quartile had a significantly higher hazard ratio for MASLD compared to those in the lowest quartile.
• The TyG index appears to be particularly useful for identifying MASLD risk in individuals with normal blood pressure.

This study suggests that the TyG index could be a useful, non-invasive tool for predicting the development of MASLD in individuals without obesity. However, further research is needed to validate its effectiveness and explore its predictive value for more advanced liver conditions. Limitations include its observational design, potential missing data on lifestyle factors, and reliance on ultrasound for diagnosis.