title: The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease.
abstract: BACKGROUND
  The triglyceride and glucose index (TyG) has been proposed as a marker of insulin resistance. We aimed to investigate the ability of TyG, through comparing with the predictive value of alanine aminotransferase (ALT), to identify individuals at risk for nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  A cross-sectional study was conducted in a Chinese health examination cohort of 10 761 people aged above 20 years. NAFLD was diagnosed by ultrasonography.
  
  
  RESULTS
  Compared with the participants in the lowest quartile of TyG, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were 1.8 (1.5-2.1), 3.0 (2.5-3.5), and 6.3 (5.3-7.5) for those in the second, the third, and the fourth quartile of TyG, whereas the corresponding ORs (95% CI) for NAFLD were 1.5 (1.3-1.7), 1.9 (1.6-2.2), and 3.1 (2.6-3.7) for the upper three quartiles of ALT. These results suggested that TyG was superior to ALT in association with NAFLD risk. According to the ROC analysis, the optimal cut-off point of TyG for NAFLD was 8.5 and the area under the ROC curve (AUC) was 0.782 (95% CI 0.773-0.790), with 72.2 and 70.5% sensitivity and specificity, respectively. The AUC of TyG was larger than that of ALT (0.715 (95% CI 0.705-0.725), P for difference <0.0001), whereas the largest AUC was obtained when adding TyG to ALT (0.804 (95% CI 0.795-0.812), P for difference <0.0001).
  
  
  CONCLUSIONS
  TyG is effective to identify individuals at risk for NAFLD. A TyG threshold of 8.5 was highly sensitive for detecting NAFLD subjects and may be suitable as a diagnostic criterion for NAFLD in Chinese adults.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Du
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Health Examination, Wuhan Iron and Steel Company (WISCO) General Hospital, 29 Metallurgical Avenue, Wuhan, 430080, China.
authors.forename: Huiming
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, Wuhan Iron and Steel Company (WISCO) General Hospital, 29 Metallurgical Avenue, Wuhan, 430080, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Lin
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
authors.forename: Junhui
authors.initials: J
authors.lastname: Xie
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China. xfyu188@163.com.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Yu
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000000981:diagnostic imaging; D016017:Odds Ratio; D012372:ROC Curve; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D000410:Alanine Transaminase
keywords: Alanine aminotransferase; Insulin resistance; Nonalcoholic fatty liver disease; The triglyceride and glucose index