Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 20;15(1):30665.
doi: 10.1038/s41598-025-12658-4.

Relationship between triglyceride and glucose related indexes and MAFLD in rural populations of northwest China

Shipeng Gao  1   2 , Xinyu Peng  3 , Shijie Zhang  3 , Jing Yang  3 , Shuxia Guo  1   2 , Yu Li  1   2 , Rulin Ma  1   2 , Yunhua Hu  1   2 , Keerman Mulatibieke  1   2 , Xianghui Zhang  1   2 , Xinping Wang  1   2 , Jia He  4   5 , Heng Guo  6   7
Affiliations

Relationship between triglyceride and glucose related indexes and MAFLD in rural populations of northwest China

Shipeng Gao et al. Sci Rep. .

Abstract

Research has shown inconsistent links between triglyceride and glucose related indexes (TyG-related indexes) and metabolic dysfunction-associated fatty liver disease (MAFLD) across various groups and areas. Our research focuses on exploring these connections to improve early identification and prevention of MAFLD among rural residents in Xinjiang, China. A total of 10,703 rural residents were included in this cohort study. Cox regression modeling, receiver operating characteristic curves (ROC), restricted cubic spline (RCS) scores, subgroup analyses, and sensitivity analyses were used to conduct the study. Over a 5.7-year follow-up, 5.6% of participants developed MAFLD. Higher TyG-related indexes were linked to increased MAFLD risk after adjusting for confounders (P < 0.05). TyG-WHtR increased significantly in both sexes. The top quartile of TyG, TyG-BMI, TyG-WC, and TyG-WHtR had higher MAFLD risk compared to the bottom quartile, with TyG-BMI being the strongest predictor, particularly in unmarried individuals aged 18-30. Nonlinear relationships were observed for most TyG-related indexes and MAFLD risk, except for male TyG. ROC analysis confirmed the diagnostic value of TyG-related indexes for predicting MAFLD. TyG-related indexes were independently associated with MAFLD, with a stronger association observed in females. Furthermore, TyG-related indexes demonstrated predictive value for MAFLD, with TyG-BMI exhibiting the most robust predictive performance, particularly among unmarried individuals aged 18-30.

Keywords: Cohort study; MAFLD; Risk; Rural area; TyG-related indexes.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Informed consent: Informed consent was obtained from all subjects involved in the study. Institutional review board: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Ethics Review Board (IERB) of the First Affiliated Hospital of Shihezi University School of Medicine (IERB no.: 2016–121-01).

Figures

Fig. 1
Fig. 1
Flowchart showing the final selection process.
Fig. 2
Fig. 2
RCS analysis of TyG-related indexes and MAFLD risk. Adjusted age group, sex, TC, HDL-C, LDL-C, SCr, education, marital status, smoking, drinking, and movement. Male and female groups were not adjusted for sex. TyG, triglyceride and glucose index; BMI, body mass index; WC, waist circumference; WHtR, waist-to-Height Ratio.
Fig. 3
Fig. 3
Subgroup analysis. A, Subgroup analysis of TyG; B, Subgroup analysis of TyG-BMI; C, Subgroup analysis of TyG-WC; D, Subgroup analysis of TyG-WHtR. Adjusted by age group, sex, TC, HDL-C, LDL-C, SCr, education, marital status, smoking, drinking, and movement. Variables related to subgroups were not adjusted during the analysis. For example, TC, HDL-C, and LDL-C were not adjusted for the dyslipidemia subgroup. TyG, triglyceride and glucose index; BMI, body mass index; WC, waist circumference; WHtR, waist-to-Height Ratio; T2DM, Diabetes mellitus type 2.
See this image and copyright information in PMC

References

    1. Association, H. B. O. C. M. Guidelines for the Prevention and Treatment of Metabolism-related (Non-alcoholic) Fatty Liver Disease (2024 Edition). Chin. J. Hepatol.32(5), 418–434 (2024). - PubMed
    1. Tarantino, G., Citro, V. & Capone, D. Nonalcoholic Fatty Liver Disease: A Challenge from Mechanisms to Therapy. J. Clin. Med.9(1), 15 (2019). - PMC - PubMed
    1. Wang, Y. et al. Cardiovascular and renal burdens among patients with MAFLD and NAFLD in China. Front. Endocrinol. (Lausanne)13, 968766 (2022). - PMC - PubMed
    1. Lee, H. et al. Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study. Clin. Gastroenterol. Hepatol.19(10), 2138-2147.e10 (2021). - PubMed
    1. Sakura Y, Mohammed E, Takumi K, et al. MAFLD identifies patients with significant hepatic fibrosis better than NAFLD[J]. Liver International, (2020). - PubMed

LinkOut - more resources