Relationship between the triglyceride-glucose index and non-alcoholic fatty liver disease among individuals with atrial fibrillation.

Abstract

Background: The triglyceride-glucose (TyG) index serves as a reliable surrogate marker of insulin resistance. Accumulating evidence links an elevated TyG index to increased cardiovascular risk, but its relationship with nonalcoholic fatty liver disease (NAFLD) in atrial fibrillation (AF) patients remains underexplored. This study aimed to investigate the association between the TyG index and NAFLD incidence among AF patients.

Methods: We conducted a retrospective analysis of 298 AF patients from a single tertiary care center. NAFLD was diagnosed via hepatic ultrasonography after secondary causes were excluded. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Logistic regression models were employed to assess the independent association between the TyG index and NAFLD.

Results: The NAFLD prevalence was 27.9% (83/298). Patients with NAFLD presented significantly greater TyG index values (8.90 ± 0.05 vs. 8.62 ± 0.04; P < 0.001). After multivariable adjustment, each 1-unit increment in the TyG index independently predicted NAFLD (OR 2.194, 95% CI 1.149-4.190; P = 0.017). Receiver operating characteristic curve analysis demonstrated moderate discriminative ability (AUC 0.667, 95% CI 0.601-0.732). A dose-response relationship was observed (P for trend < 0.001), with NAFLD incidence increasing progressively across TyG tertiles (12.87%, 29.81%, and 40.82%).

Conclusions: An elevated TyG index is an independent risk factor for NAFLD in AF patients, suggesting a shared metabolic pathophysiology between insulin resistance, hepatic steatosis, and cardiac arrhythmia. The TyG index may serve as a readily available tool for NAFLD risk stratification in this high-risk population.