Utility of triglyceride-glucose index for hepatic steatosis and fibrosis in severe obesity.

Abstract

Background: Obesity has become a significant global health issue, linked to a range of metabolic disorders The Triglyceride-Glucose (TyG) index has shown a robust association with well-established markers of metabolic dysfunction.

Methods: This was a cross-sectional study involving people with a BMI exceeding 40 kg/m² or a BMI between 35 and 40 kg/m² accompanied by 2 comorbidities. These individuals were referred for metabolic surgery, specifically sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). The data were collected at baseline and during various post-surgical follow-up intervals.

Results: This cross-sectional study included 1,005 participants with severe obesity who were candidates for bariatric surgery. The cohort comprised 813 females (80.9%) and 192 males (19.2%), with a mean age of 37.95 ± 10.52 years. Approximately 80% of participants were diagnosed with grade 2 or 3 fatty liver disease. Among those who underwent elastography, 38.7% presented with hepatic fibrosis. The majority of participants with steatosis and fibrosis were female, accounting for 77.2% and 72.1% of cases, respectively. Additionally, both the TyG index and HOMA-IR levels were significantly elevated in individuals with moderate to severe steatosis and hepatic fibrosis. The area under the curve (AUC) for steatosis and fibrosis prediction was 0.65. The TyG index emerged as an independent predictor for hepatic fibrosis [OR (95% CI): 8.262 (3.468-19.684), p < 0.001] and moderate to severe hepatic steatosis [OR (95% CI): 9.4 (4.228-20.904), p < 0.001].

Conclusion: The TyG index stands out as a valuable biomarker for evaluating metabolic health in people with severe obesity. It offers clinicians a pragmatic tool for managing obesity-related metabolic disorders, enabling early detection and timely intervention to enhance patient care.