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The following is a summary of “Association between triglyceride-glucose related indices and at-risk NASH in U.S. adults with NAFLD: results from NHANES 2017-2020,” published in the June 2025 issue of Frontiers in Endocrinology by Ma et al. 

Nonalcoholic fatty liver disease (NAFLD) has been closely associated with insulin resistance (IR), obesity, and metabolic syndrome (MetS), affecting a significant portion of the global population.  

Researchers conducted a retrospective study to assess the association between triglyceride-glucose (TyG) related indices and at-risk nonalcoholic steatohepatitis (NASH) in a nationally representative cohort of NAFLD.  

They analyzed data from adults with NAFLD diagnosed by vibration-controlled transient elastography (VCTE) in the 2017–2020 National Health and Nutrition Examination Survey (NHANES). At-risk NASH was defined using the FibroScan-AST (FAST) score and 5 TyG related indices—TyG, TyG-waist circumference (TyG-WC), TyG-waist-to-hip ratio (TyG-WHR), TyG-waist-to-height ratio (TyG-WtHR), and TyG-body mass index (TyG-BMI)—were calculated. Weighted logistic regression, stratified analyses, restricted cubic spline (RCS), and receiver operating characteristic (ROC) analyses were performed, adjusting for demographic and clinical confounders.  

The results showed that 10% of participants had at-risk NASH. Composite indices—TyG-WC, TyG-WHR, TyG-waist-to-height ratio, and TyG-BMI—exhibited higher ORs than the TyG index alone in Model 3, TyG-WtHR demonstrated the strongest association both as a continuous variable and across tertiles, with a near-linear dose-response. The RCS analysis found no significant nonlinear associations for composite indices, while TyG showed a significant nonlinear relationship. Stratified analyses indicated increased risk among males, middle-aged adults, and Non-Hispanic Black individuals. The ROC analysis highlighted TyG-WC’s discriminative ability, while TyG-WtHR achieved a balance between sensitivity and specificity.  

Investigators concluded that TyG-related indices were significantly associated with at-risk NASH in patients with NAFLD, supporting their use as non-invasive, cost-effective biomarkers for early risk stratification and targeted interventions in gastroenterology. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1604991/full