Diagnosis of metabolic dysfunction-associated steatotic liver disease by triglyceride glucose-body mass index: A systematic review and meta-analysis.

Abstract

Introduction and objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common globally, but current diagnostic methods are inaccessible. This study aims to evaluate the efficacy of triglyceride glucose-body mass index (TyG-BMI) as a noninvasive diagnostic tool for MASLD.

Materials and methods: Embase, PubMed, Cochrane Library, and Web of Science up to July 2025 were searched for related studies. Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was utilized for quality assessment. The effect size, odds ratio (OR), specificity, sensitivity, positive/negative likelihood ratios, diagnostic odds ratio, and heterogeneity were pooled using Stata18.0 and Meta-Disc1.4. The summary receiver operating characteristic (SROC) curves were plotted and the area under the curve (AUC) values were calculated. Random- or fixed-effects models were adopted based on the results of the heterogeneity test. Moreover, we investigated the source and influence of heterogeneity by subgroup and sensitivity analyses, and examined publication bias.

Results: Twenty-nine studies were included. The meta-analysis revealed a higher TyG-BMI in MASLD patients than in non-MASLD patients (SMD 3.09, 95 % CI 2.49-3.68, P < 0.001). For each one-unit increase in TyG-BMI, the MASLD risk rose by 5 % (OR 1.05, 95 % CI 1.04-1.07, P < 0.001). The pooled sensitivity, specificity, and AUC of the diagnostic efficacy of TyG-BMI were 0.81 (95 % CI 0.77-0.85), 0.72 (95 % CI 0.67-0.77), and 0.83 (95 % CI 0.80-0.86), respectively. The stratified analysis by sex revealed that the diagnostic efficacy was superior in females (sensitivity: 0.82, specificity: 0.80).

Conclusions: TyG-BMI, a cost-efficient and convenient indicator, is favorable for diagnosing MASLD, especially in females, which is worth popularizing.