甘油三酯-葡萄糖指数及其相关指数对瘦型非酒精性脂肪肝病的预测价值

戴青云; 武艳; 郭秦昊; 李磊; 王箴; 戚建君

doi:10.16766/j.cnki.issn.1674-4152.004247

甘油三酯-葡萄糖指数及其相关指数对瘦型非酒精性脂肪肝病的预测价值

doi: 10.16766/j.cnki.issn.1674-4152.004247

戴青云¹,
武艳¹,
郭秦昊¹,
李磊¹,
王箴^2, ,,
戚建君³

1.
皖南医学院研究生学院, 安徽芜湖 241002
2.
皖南医学院第一附属医院弋矶山医院全科医学科, 安徽芜湖 241000
3.
皖南医学院第一附属医院弋矶山医院检验科

基金项目:

安徽省卫生健康科研项目 AHWJ2022b054

详细信息

通讯作者:
王箴，E-mail：zhenwang80@126.com

中图分类号: R575.5
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出版历程
- 收稿日期: 2025-02-15
- 网络出版日期: 2026-01-07

Comparison of the predictive value of the TyG index and related indices for lean non-alcoholic fatty liver disease

1.
Graduate School, Wannan Medical College, Wuhu, Anhui 241002, China

摘要

摘要: 目的探讨甘油三酯-葡萄糖指数(TyG指数)反映胰岛素抵抗的能力，与非酒精性脂肪肝病(NAFLD)的关联，分析其和相关指数对瘦型非酒精性脂肪肝病的预测效能。方法选取2023年7—9月于皖南医学院第一附属医院体检中心进行体检的1 343例体检者，使用腹部超声诊断NAFLD，分为非NAFLD组(1 099例)和NAFLD(244例)，对比2组间指标差异。采用logistic回归分析探讨瘦型非酒精性脂肪肝的危险因素，绘制TyG指数及相关指数的ROC曲线，评估指标对瘦型NAFLD的预测价值。结果 TyG指数、TyG-BMI指数是瘦型NAFLD发病的独立影响因素(P＜0.05)。在总体及性别分组的ROC分析结果中显示，TyG-BMI指数的预测价值最高，曲线下面积(AUC)在总体、男性、女性分别为0.747(95% CI: 0.713~0.782)、0.725(95% CI: 0.672~0.779)、0.748(95% CI: 0.700~0.796)。结论 TyG指数和TyG-BMI指数是NAFLD的独立影响因素，均具有较好的预测价值，其中TyG-BMI指数的预测价值更高。
- 瘦型非酒精性脂肪肝病 /
- 甘油三酯-葡萄糖指数 /
- 相关指标 /
- 预测效能
Abstract: Objective To investigate the utility of the triglyceride-glucose index (TyG index) as a surrogate marker of insulin resistance, examine its association with non-alcoholic fatty liver disease (NAFLD), and assess its predictive efficacy, along with related indices, for lean NAFLD. Methods A total of 1 343 individuals who underwent health examinations at the Medical Examination Center of the First Affiliated Hospital of Wannan Medical College from June to August 2023 were selected. NAFLD was diagnosed using abdominal ultrasound, and participants were categorized into a non-NAFLD group (1 099 cases) and a NAFLD group (244 cases). Clinical indices between the two groups were compared. Logistic regression was used to explore the risk factors for lean NAFLD. Receiver operating characteristic (ROC) curve was generated to assess the predictive value of the TyG index and related indices. Results Both the TyG index and TyG-BMI index were independent risk factors for the development of lean NAFLD (P < 0.05). The ROC curve results for the total population and gender subgroups showed that the TyG-BMI index had the highest predictive value, with an area under the curve (AUC) of 0.747 (95% CI: 0.713-0.782) in the total population, 0.725 (95% CI: 0.672-0.779) in males, and 0.748 (95% CI: 0.700-0.796) in females. Conclusion Both the TyG index and TyG-BMI index are independent risk factors for NAFLD, showing good predictive ability, with the TyG-BMI index exhibiting superior predictive performance.
- Lean non-alcoholic fatty liver disease /
- TyG index /
- Correlation index /
- Predictive value

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图 1 TyG指数及相关指数预测NAFLD的ROC曲线

Figure 1. ROC curves of the TyG index and related markers for predicting NAFLD

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表 1 非NAFLD与NAFLD组患者一般资料比较

Table 1. Comparison of baseline characteristics between the non-NAFLD and NAFLD groups

组别	例数	性别[例(%)]		年龄[M(P₂₅, P₇₅)，岁]	吸烟史[例(%)]		饮酒史[例(%)]		高血压[例(%)]
组别	例数	男性	女性	年龄[M(P₂₅, P₇₅)，岁]	无	有	无	有	无	有
非NAFLD	1 099	341(31.0)	758(69.0)	54(49.0, 64.0)	985(89.6)	114(10.4)	968(88.1)	131(11.9)	872(79.3)	227(20.7)
NAFLD	244	115(47.1)	129(52.9)	57(51.3, 66.0)	211(86.5)	33(13.5)	193(79.1)	51(20.9)	160(65.6)	84(34.4)
统计量		23.008^a		-3.433^b	2.034^a		13.746^a		21.276^a
P值		＜0.001		0.001	0.154		＜0.001		＜0.001
注：^a为χ²值，^b为Z值。

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表 2 非NAFLD与NAFLD组患者临床资料比较[M(P₂₅, P₇₅)]

Table 2. Comparison of clinical data between the non-NAFLD and NAFLD groups[M(P₂₅, P₇₅)]

组别	例数	BMI	空腹血糖(mmol/L)	总胆固醇(mmol/L)	甘油三酯(mmol/L)	高密度脂蛋白(mmol/L)	低密度脂蛋白(mmol/L)
非NAFLD	1 099	21.07(20.03, 22.07)	4.91(4.58, 5.31)	5.06(4.46, 5.69)	1.10(0.80, 1.45)	1.65(1.42, 1.87)	2.81(2.36, 3.35)
NAFLD	244	21.93(21.08, 22.58)	5.29(4.90, 6.00)	5.15(4.55, 5.83)	1.64(1.09, 2.23)	1.45(1.29, 1.67)	3.00(2.51, 3.54)
Z值		-7.852	-8.790	-1.486	-9.815	-6.691	-2.752
P值		＜0.001	＜0.001	0.137	＜0.001	＜0.001	0.006

组别	例数	TyG指数	TyG-BMI指数	TG/HDL-C指数	TC/HDL-C指数	LDL-C/HDL-C指数
非NAFLD	1 099	8.38(8.05, 8.68)	175.87(164.72, 187.40)	0.66(0.44, 0.94)	3.03(2.63, 3.55)	1.72(1.38, 2.13)
NAFLD	244	8.85(8.46, 9.29)	193.50(179.96, 204.27)	1.13(0.69, 1.63)	3.49(2.92, 4.08)	2.01(1.64, 2.47)
Z值		-10.996	-12.110	-9.933	-7.268	-6.527
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 发生NAFLD影响因素的多因素logistic回归分析

Table 3. Multivariable logistic regression analysis

项目	B	SE	Waldχ²	P值	OR(95% CI)
TyG指数	0.712	0.288	6.098	0.014	2.038(1.158~3.587)
TyG-BMI指数	0.039	0.008	26.036	＜0.001	1.040(1.024~1.055)
TG/HDL-C指数	-0.101	0.159	0.402	0.526	0.904(0.663~1.234)
TC/HDL-C指数	-0.491	0.334	2.157	0.142	0.612(0.318~1.178)
LDL-C/HDL-C指数	0.671	0.382	3.091	0.079	1.956(0.926~4.133)

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表 4 TyG指数及相关指数预测与NAFLD比较

Table 4. Comparison of the predictive performance of the TyG index and related indices for NAFLD

预测指标	AUC	95% CI	灵敏度	特异度	最佳临界值	P值
总体
TyG指数	0.725	0.687~0.762	0.619	0.748	8.671	＜0.001
TyG-BMI指数	0.747	0.713~0.782	0.697	0.689	184.160	＜0.001
男性
TyG指数	0.686	0.627~0.746	0.687	0.628	8.602	＜0.001
TyG-BMI指数	0.725	0.672~0.779	0.609	0.748	191.053	＜0.001
女性
TyG指数	0.744	0.695~0.793	0.636	0.772	8.671	＜0.001
TyG-BMI指数	0.748	0.700~0.796	0.674	0.735	184.687	＜0.001

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