Association between triglyceride-glucose related indices and at-risk NASH in U.S. adults with NAFLD: results from NHANES 2017-2020

作者：Hu Ma, Wenjie Zhang, Zheng Zhao, Shuaichen Jin, Linchuan Li, Rui Zong, Wuyang Li, Ziwei Zhang, Shichang Cui, Yunmiao Pan, Jiankang Zhu, Guangyong Zhang · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1604991 · 被引用次数：6 · 研究领域：Liver Disease Diagnosis and Treatment、Diabetes, Cardiovascular Risks, and Lipoproteins、Hepatitis C virus research

Introduction: Nonalcoholic fatty liver disease (NAFLD), intricately linked to insulin resistance (IR), obesity, and metabolic syndrome (MetS), affects nearly one-third of the global population. The triglyceride-glucose (TyG) index and its derivative metrics, which integrate anthropometric measures, have emerged as cost-effective tools for assessing IR severity and their associations with NAFLD severity. However, evidence on their association with at-risk nonalcoholic steatohepatitis (NASH), a progressive phenotype characterized by hepatic fibrosis and inflammation, remains limited. This study aimed to evaluate the relationship between TyG related indices and at-risk NASH in a nationally representative NAFLD cohort. Methods: Using data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), adults with NAFLD diagnosed via vibration-controlled transient elastography (VCTE) were analyzed. At-risk NASH was defined using the FibroScan-AST (FAST) score. Five TyG related indices (TyG, TyG-WC, TyG-WHR, TyG-WtHR, TyG-BMI) were calculated and analyzed through weighted logistic regression, stratified analyses, restricted cubic spline (RCS), and receiver operating characteristic (ROC) analyses. Adjustments included demographics and clinical confounders. Results: Among participants, 10% exhibited at-risk NASH. Composite indices (TyG-WC, TyG-WHR, TyG-WtHR, TyG-BMI) each showed higher ORs than TyG alone in Model 3. TyG-WtHR exhibited the strongest association both as a...