Cumulative Triglyceride-Glucose Index and Risk of Metabolic Dysfunction–Associated Fatty Liver Disease: Findings from the Kailuan Cohort

Chao Zhang,1 Zixin Zhang,2,3 Qi Qi,2,3 Lei Li,3 Jie Deng,3 Jiao Zheng,3 Yue Jiang,1 Quanle Han,3 Shouling Wu,4 Kangbo Li5 1Catheterization Unit, Tangshan Gongren Hospital, Tangshan, People’s Republic of China; 2Hebei Medical University, Shijiazhuang, People’s Republic of China; 3Department of Cardiology, Tangshan Gongren Hospital, Tangshan, People’s Republic of China; 4Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China; 5School of Clinical Medicine, North China University of Science and Technology, Tangshan, People’s Republic of ChinaCorrespondence: Quanle Han, Department of Cardiology, Tangshan Gongren Hospital, No. 27, Wenhua Road, Lubei District, Tangshan, 063000, People’s Republic of China, Email quanle.han@outlook.comPurpose: This study aimed to investigate the relationship between the cumulative triglyceride-glucose (cum-TyG) index and the risk of new-onset metabolic dysfunction-associated fatty liver disease (MAFLD).Patients and Methods: The present study involved 89,831 participants selected from the Kailuan cohort. The cum-TyG index was evaluated by determining the weighted average of TyG index values recorded at each visit. Participants were divided into four groups based on the quartiles of cum-TyG index or the duration of high TyG index exposure. To investigate the association between levels of the cum-TyG index and the risk of new-onset MAFLD, Cox proportional hazards regression analysis was performed.Results: A total of 16,387 cases of new-onset MAFLD were recorded over a median follow-up duration of 10 years. The Cox proportional hazards regression analysis indicated that the hazard ratios (HRs) and 95% confidence intervals (CIs) significantly increased in quartile 2 (HR: 1.306, 95% CI: 1.246– 1.367), quartile 3 (HR: 1.423, 95% CI: 1.357– 1.492), and quartile 4 (HR: 1.648, 95% CI: 1.571– 1.730), when compared to quartile 1. A similar pattern was noted for 2-year high TyG index exposure (HR: 1.267, 95% CI: 1.200– 1.338), 4-year high TyG index exposure (HR: 1.642, 95% CI: 1.557– 1.731), and 6-year high TyG index exposure (HR: 2.122, 95% CI: 2.010– 2.239), when compared to 0-year high TyG index exposure.Conclusion: The cum-TyG index may provide important information for risk assessment of MAFLD.Keywords: insulin resistance, the cumulative triglyceride-glucose index, metabolic-dysfunction associated fatty liver disease