BMC endocrine disorders · 2026
Triglyceride-glucose body mass index and metabolic dysfunction-associated steatotic liver disease in hospitalized patients with type 2 diabetes: a sex-stratified cross-sectional study.
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He Qiao-Juan, Xu Yun-Yun, Tan Xue, Yin Ying-Chuan
Аннотация
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in patients with type 2 diabetes mellitus (T2DM). The triglyceride-glucose body mass index (TyG-BMI), which integrates insulin resistance and adiposity, may improve MASLD risk stratification, but evidence in hospitalized T2DM patients remains limited.
METHODS: This hospital-based cross-sectional study included 324 hospitalized adults with T2DM. MASLD was assessed by abdominal ultrasonography. TyG-BMI was calculated as TyG index × BMI and compared with conventional metabolic indices using receiver operating characteristic analysis, multivariable logistic regression, spline modelling, reclassification metrics, subgroup and sensitivity analyses. Testosterone-related analyses were performed in male patients.
RESULTS: MASLD was identified in 182 patients. TyG-BMI showed the highest discrimination for MASLD, with an area under the curve of 0.821 (95% CI: 0.775-0.866), outperforming TyG, BMI, atherogenic index of plasma, and hepatic steatosis index. The optimal cut-off was 227.22, with 75.1% sensitivity and 78.7% specificity. In the fully adjusted model, TyG-BMI remained independently associated with MASLD as a continuous variable and across quartiles; patients in the highest quartile had markedly higher odds of MASLD than those in the lowest quartile. TyG-BMI also improved reclassification beyond TyG alone. In men, testosterone was inversely correlated with TyG-BMI and showed a nonlinear association with MASLD risk.
CONCLUSIONS: TyG-BMI showed better non-invasive discrimination for MASLD than conventional metabolic indices in hospitalized patients with T2DM. As a readily available marker integrating insulin resistance and adiposity, TyG-BMI may be useful for first-line MASLD risk stratification in endocrinology inpatient settings. Testosterone-related findings in men were exploratory and warrant prospective validation.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: This hospital-based cross-sectional study included 324 hospitalized adults with T2DM. MASLD was assessed by abdominal ultrasonography. TyG-BMI was calculated as TyG index × BMI and compared with conventional metabolic indices using receiver operating characteristic analysis, multivariable logistic regression, spline modelling, reclassification metrics, subgroup and sensitivity analyses. Testosterone-related analyses were performed in male patients.
RESULTS: MASLD was identified in 182 patients. TyG-BMI showed the highest discrimination for MASLD, with an area under the curve of 0.821 (95% CI: 0.775-0.866), outperforming TyG, BMI, atherogenic index of plasma, and hepatic steatosis index. The optimal cut-off was 227.22, with 75.1% sensitivity and 78.7% specificity. In the fully adjusted model, TyG-BMI remained independently associated with MASLD as a continuous variable and across quartiles; patients in the highest quartile had markedly higher odds of MASLD than those in the lowest quartile. TyG-BMI also improved reclassification beyond TyG alone. In men, testosterone was inversely correlated with TyG-BMI and showed a nonlinear association with MASLD risk.
CONCLUSIONS: TyG-BMI showed better non-invasive discrimination for MASLD than conventional metabolic indices in hospitalized patients with T2DM. As a readily available marker integrating insulin resistance and adiposity, TyG-BMI may be useful for first-line MASLD risk stratification in endocrinology inpatient settings. Testosterone-related findings in men were exploratory and warrant prospective validation.
CLINICAL TRIAL NUMBER: Not applicable.