ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1516187
This article is part of the Research TopicIs Insulin Resistance the Eminence Grise of Aging and Non-Communicable Chronic Diseases?View all 12 articles
U-shaped relationship between the triglyceride glucose index and the risk of incident diabetes among MASLD adults: a retrospective cohort study
Provisionally accepted
- 1Shenzhen Second People's Hospital Dapeng New District Nan'ao Hospital, Shenzhen, China
- 2Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
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Background: Previous research has indicated that the triglyceride glucose index (TyG-i) may serve as a potential risk factor for type 2 diabetes (T2D). However, there is a paucity of studies addressing the relationship between TyG-i and T2D, specifically in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Consequently, this longitudinal study aims to investigate the association between TyG-i and the onset of T2D in a cohort of Japanese adults with MASLD. Methods: This retrospective cohort study included a total of 2,507 subjects diagnosed with MASLD. To evaluate the association between the TyG-i and the risk of developing T2D, Cox proportional hazards regression models were employed to estimate hazard ratios (HR) along with 95% confidence intervals (CI). Additionally, nonlinear associations between them were investigated utilizing restricted cubic spline models. Results: During a mean follow-up period of 6.00 years, a total of 204 adults with MASLD developed T2D. After adjusting for potential confounding factors, elevated TyG-i was found to be independently associated with an increased risk of developing T2D (HR: 1.48, 95% CI: 1.05-2.09, P = 0.0256). Additionally, a U-shaped relationship between the TyG-i and the incidence of T2D was identified. A significant negative association was observed between TyG-i and T2D risk when TyG-i levels were below 7.94 (HR: 0.21, 95%CI: 0.07-0.66, P = 0.0072). Conversely, TyG-i values exceeding the threshold were positively correlated with T2D risk (HR: 1.76, 95% CI: 1.23-2.52, P = 0.0020). Conclusion: A U-shaped association was identified between baseline TyG-i and the incidence of T2D in a Japanese population with MASLD. This inflection point in TyG-i serves as a valuable clinical indicator to differentiate individuals at lower versus higher risk of developing T2D. These findings indicate that maintaining TyG-i near the inflection point may be beneficial in reducing the risk of developing diabetes in patients with MASLD.
Keywords: Metabolic dysfunction-associated steatotic liver disease, type 2 diabetes, triglyceride, Triglyceride glucose index, Insulin Resistance
Received: 24 Oct 2024; Accepted: 06 Aug 2025.
Copyright: © 2025 Cao, Zhang, Han, Hu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haofei Hu, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
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