Predictive significance of the triglyceride glucose index and associated indicators for hepatic steatosis in type 2 diabetes patients with diverse body mass index.

Abstract

Introduction: The objective was to explore the value of triglyceride glucose index and related indicators in predicting hepatic steatosis in type 2 diabetes patients (T2DM) with different body mass indexes (BMI).

Material and methods: Clinical data from 221 hospitalised patients withT2DM, diagnosed with hepatic steatosis via transient elastography, were collected and analysed. Patients with a BMI of 24 kg/m² or higher were designated as the high-BMI group, while those with a BMI below 24 kg/m² comprised the low-BMI group. Relevant indicators, including triglyceride glucose index (TyG), TyG-BMI index (TyG-BMI), and TyG-waist circumference (TyG-WC), were obtained.

Results: TyG, TyG-BMI, and TyG-WC were all significantly elevated in the high-BMI group relative to the low-BMI group (p < 0.01).Within both high- and low-BMI categories of T2DM patients, TyG, TyG-BMI, and TyG-WC were markedly higher in patients with hepatic steatosis than in those without the condition (p < 0.01 or p < 0.05). Multivariate logistic regression analysis identified TyG-BMI as an independent risk factor for hepatic steatosis in high-BMI T2DM patients (p < 0.01), while glycosylated haemoglobin (HbA1c) and TyG-WC emerged as independent risk factors in low-BMI T2DM patients (p < 0.01 or p < 0.05). Receiver operating characteristic curve analysis for predicting hepatic steatosis in high-BMI T2DM patients demonstrated that TyG-BMI had an area under the curve of 0.84 (p < 0.01) with a cut-off value of 241.36, yielding a sensitivity of 79.80% and a specificity of 83.30%. For low-BMI T2DM patients, the TyG-WC index had an area under the curve of 0.80 (p < 0.01), a cut-off value of 824.63, a sensitivity of 68.30%, and a specificity of 84.90%.

Conclusion: In T2DM patients, TyG-BMI can predict hepatic steatosis in high-BMI patients, and TyG-WC can predict hepatic steatosis in low-BMI patients. The latter is negatively correlated with HbA1c.