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Triglyceride glucose-waist to height ratio: a novel and effective marker for identifying hepatic steatosis in individuals with type 2 diabetes mellitus

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Abstract

Background

The triglyceride-glucose index (TyG), and TyG-driven parameters incorporating TyG and obesity indices have been proposed as reliable indicators of insulin resistance and its related comorbidities. This study evaluated the effectiveness of these indices in identifying hepatic steatosis in individuals with Type 2 diabetes (T2DM).

Methods

This was a cross-sectional study consisting of 175 patients with T2DM (122 with and 53 without NAFLD). TyG index, triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR) were determined using standard formulas. Controlled attenuation parameter (CAP) was measured by transient elastography (FibroScan).

Results

Among obesity parameters, CAP showed the strongest correlation with WHtR, followed by BMI and WC (all P < 0.001). Regression analyses demonstrated TyG-WHtR as a significant predictor of NAFLD with the highest odds ratio, reaching 10.69 (95% CI: 1.68–68.22) for the top quartile (Q4) compared to the first quartile (P = 0.01), followed by TyG-BMI (Q4: 6.75; 95% CI: 1.49–30.67) and TyG-WC (Q4: 5.90; 95% CI: 0.99–35.18). Moreover, TyG-WHtR presented the largest AUC for detection of NAFLD (0.783, P < 0.001) in ROC analysis, followed by TyG-BMI (AUC: 0.751, P < 0.001), TyG-WC (AUC: 0.751, P < 0.001), and TyG (AUC: 0.647, P = 0.002). TyG-WHtR value of 5.58 (sensitivity: 79%, specificity: 68%, P < 0.001) was the best cut-off point to identify hepatic steatosis in this population.

Conclusions

This study confirmed that the TyG-related indices comprising TyG and obesity parameters can identify hepatic steatosis more successfully than TyG alone. Furthermore, our results highlighted TyG-WHtR as a simple and effective marker for screening fatty liver in patients with T2DM, which may be used practically in clinical setting.

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Acknowledgements

This study was supported by Iran University of Medical Sciences (IUMS) (Research project number: 98-4-24-16770).

Author contributions

M.E.K., M.M., and F.A.S. were involved in the conception and design of the study. S.N. and H.C. were involved in data collection. Data were analyzed and interpreted by F.A.S. who was also involved in drafting the manuscript. All authors have participated in reviewing the manuscript and approved the final version.

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Authors and Affiliations

  1. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran

    Mojtaba Malek

  2. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran

    Mohammad E. Khamseh, Haleh Chehrehgosha, Sohrab Nobarani & Fariba Alaei-Shahmiri

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  1. Mojtaba Malek
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  2. Mohammad E. Khamseh
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Correspondence to Fariba Alaei-Shahmiri.

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The current study was carried out under Helsinki Declaration and approved by ethics committee of Iran University of Medical Sciences (Approval number: IR.IUMS.REC.1398.1045).

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Malek, M., Khamseh, M.E., Chehrehgosha, H. et al. Triglyceride glucose-waist to height ratio: a novel and effective marker for identifying hepatic steatosis in individuals with type 2 diabetes mellitus. Endocrine 74, 538–545 (2021). https://doi.org/10.1007/s12020-021-02815-w

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