TyG-WC and TyG-WHtR Indices Predict Liver Events in Type 2 Diabetes
Overview
In a prospective cohort of 18,105 individuals with type 2 diabetes, higher TyG-WC and TyG-WHtR indices were independently associated with increased risk of liver-related events (LRE) over a median 13.4-year follow-up. These associations were particularly strong in high-risk subgroups, such as excessive alcohol consumers and those with elevated FIB-4 scores.
Background
Chronic liver disease is a major cause of mortality worldwide, often diagnosed late after severe complications arise. Type 2 diabetes (T2D) significantly increases the risk of liver-related events (LRE), including cirrhosis and hepatocellular carcinoma. Current risk stratification tools like the FIB-4 score have limitations in T2D populations, prompting the search for more effective biomarkers. The triglyceride-glucose (TyG) index and its derivatives, which reflect insulin resistance, have emerged as potential predictors of liver disease progression but require validation for LRE risk in T2D patients.
Data Highlights
TyG Index Parameter
Highest vs Lowest Quartile HR (95% CI)
Significance
TyG-WC
1.63 (1.12-2.38)
Significant
TyG-WHtR
1.98 (1.36-2.89)
Significant
TyG
Not significant
NS
TyG-BMI
Not significant
NS
Key Findings
Among 18,105 T2D patients, 507 developed liver-related events during median 13.4 years follow-up.
Higher TyG-WC and TyG-WHtR quartiles were independently associated with increased LRE risk (HR 1.63 and 1.98 respectively).
TyG and TyG-BMI indices showed no significant association with LRE risk.
Restricted cubic spline analyses confirmed linear dose-response relationships for TyG-WC and TyG-WHtR with LRE risk.
Associations were stronger in high-risk subgroups, including excessive alcohol consumers and those with FIB-4 scores ≥1.3.
In individuals with FIB-4 ≥1.3, TyG-WHtR association with LRE risk was notably higher (HR 2.59) compared to those with lower FIB-4.
Clinical Implications
TyG-WC and TyG-WHtR indices, which combine metabolic and anthropometric measures, may serve as practical, cost-effective tools to improve early identification and risk stratification of liver-related events in patients with type 2 diabetes. Incorporating these indices into routine clinical assessment could enhance surveillance strategies, especially for patients with additional risk factors such as alcohol use or elevated fibrosis scores.
Conclusion
This study establishes TyG-WC and TyG-WHtR as independent predictors of liver-related events in type 2 diabetes, supporting their clinical utility for risk stratification. These indices offer promising avenues for improving early detection and management of liver complications in this high-risk population.
References
UK Biobank Study -- Relationship Between Triglyceride-Glucose Indices and Liver Events in Individuals with Type 2 Diabetes
