Researchers have established in a new study that triglyceride-glucose (TyG) levels have a U-shaped correlation with the development of diabetes in patients with non-alcoholic fatty liver disease (NAFLD). The study was published in the journal of BMC Lipids in Health and Disease by Xiaomin and fellow researchers. This study aimed to investigate the impact of baseline TyG values on the development of diabetes in normoglycemic adults with NAFLD.
Diabetes is a state of hyperglycemia that is most often caused by insulin resistance (IR) or inadequate insulin secretion. NAFLD is the most prevalent global chronic liver illness, with the prevalence estimated at 25% of adults. The TyG index, which is measured based on triglyceride (TG) levels and fasting plasma glucose (FPG) levels, is widely regarded as being linked with IR. In NAFLD, though, there is no well-characterized direct correlation between the TyG levels and the risk of diabetes.
2,506 normoglycemic Japanese adults with NAFLD, who received routine health check-ups at Murakami Memorial Hospital from 2004 to 2015, were included in this cohort study. Statistical methods like restricted cubic splines and two-piecewise linear regression were used by the researchers to analyze the association of TyG values with diabetes risk. The follow-up duration was 11 years.
Key Findings
• Among 2,506 individuals (mean age: 44.78 ± 8.32 years; 81.09% men), 203 patients (8.10%) developed diabetes during the follow-up period.
• There was a U-shaped correlation between TyG levels and risk of diabetes.
• The turning point of TyG levels was 7.82 (95% CI: 7.72-8.00).
• Below the cut-point, every one-unit increase in TyG levels was associated with a 93% reduced probability of diabetes (HR = 0.07, 95% CI: 0.01–0.32, p=0.001).
• Above this cutoff, for every one-unit increase in TyG levels, diabetes risk was 70% higher (HR = 1.70, 95% CI: 1.19–2.44, p=0.004).
This research presents strong evidence for a U-shaped correlation between TyG levels and diabetes onset in NAFLD patients. Both the lower and higher levels of TyG are associated with increased risk of diabetes. These results highlight the need for close metabolic monitoring and prompt intervention to prevent this at-risk population.
Reference:
Liang, X., Lai, K., Li, X. et al. Non-linear relationship between triglyceride glucose index and new-onset diabetes among individuals with non-alcoholic fatty liver disease: a cohort study. Lipids Health Dis 24, 94 (2025). https://doi.org/10.1186/s12944-025-02518-5
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