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August 5, 2026Open Access

Triglyceride glucose–body mass index versus conventional lipid ratios for newly detected, ultrasound-defined hepatic steatosis compatible with MASLD: a retrospective cohort study in community-dwelling older adults with type 2 diabetes and hypertension

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Key result

TyG-BMI tracks hepatic steatosis risk but adds no discriminative benefit over BMI alone.

  • OR 2.03
  • 95% CI 1.62-2.54
  • n=453

Why the study?

Does TyG-BMI predict newly detected hepatic steatosis better than conventional lipid ratios or BMI alone in older adults with type 2 diabetes and hypertension?

Population

453 community-dwelling older adults with type 2 diabetes and hypertension, free of baseline steatosis

Comparison

Triglyceride glucose-body mass index (TyG-BMI) vs TyG-WC, six lipid ratios, and BMI alone

Design

Cohort

Follow-up

3 annual examinations (2023-2025)

Authors

LZLing ZhangCommunity Health CenterYYYanqin YuCommunity Health CenterYZYing ZhangTianjin University of Science and Technology

Discussion

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Implication

While TyG-BMI is associated with newly detected hepatic steatosis in older adults with diabetes and hypertension, it does not provide clinically meaningful incremental predictive value over BMI alone.

Key Points

  • This study aimed to evaluate the effectiveness of TyG-BMI compared to conventional lipid ratios in predicting hepatic steatosis in older adults with type 2 diabetes and hypertension.
  • Retrospective cohort of 453 older adults with type 2 diabetes and hypertension over three annual examinations from 2023 to 2025.
  • Logistic regression was used to assess associations, comparing TyG-BMI with TyG-WC and six lipid ratios for hepatic steatosis detection.
  • Cumulative risk was estimated, with multiple sensitivity analyses for outcome definitions.
  • Newly detected steatosis was found in 203 participants (44.8% detection rate).
  • TyG-BMI had the strongest association with hepatic steatosis (OR 2.03, 95% CI 1.62–2.54).
  • Discrimination under various outcome definitions was moderate, with TyG-BMI outperforming some lipid ratios but not BMI alone.

Study Design

Type

Cohort (n=453)

Structured PICO

Does TyG-BMI predict newly detected hepatic steatosis better than conventional lipid ratios or BMI alone in older adults with type 2 diabetes and hypertension?

P
Population
453 community-dwelling older adults with type 2 diabetes and hypertension, free of baseline steatosis, followed from 2023 to 2025.
E
Exposure
Triglyceride glucose-body mass index (TyG-BMI)
C
Comparator
TyG-WC, six lipid ratios (TyG, LDL/HDL-C, NHHR, AIP, UHR), and BMI alone
O
Outcome
Newly detected, ultrasound-defined hepatic steatosis compatible with MASLD (ever-positive over the fixed window to 2025)surrogate

Main Result

Odds Ratio: 2.03 (95% CI 1.62–2.54)

While TyG-BMI is associated with newly detected hepatic steatosis in older adults with diabetes and hypertension, it does not provide clinically meaningful incremental predictive value over BMI alone.

Limitations

  • Misclassification direction undetermined due to read reversion falling with body mass only within ungraded reads
  • Requires external validation
  • requires external validation
  • retrospective design

Cite This Study

Zhang et al. (2026) conducted a cohort in Metabolic dysfunction-associated steatotic liver disease (MASLD) (n=453). Triglyceride glucose-body mass index (TyG-BMI) vs. BMI alone and conventional lipid ratios was evaluated on Newly detected, ultrasound-defined hepatic steatosis compatible with MASLD (ever-positive) (OR 2.03, 95% CI 1.62-2.54). TyG-BMI was associated with newly detected hepatic steatosis (OR per 1-SD 2.03; 95% CI 1.62-2.54) but did not discriminate significantly better than BMI alone (ΔAUC 0.011; P=0.45).

synapsesocial.com/papers/6a72e841226790f370657e85https://doi.org/10.5281/zenodo.21775796
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Body mass index accounts for most of the discrimination of the triglyceride glucose–body mass index for newly detected hepatic steatosis in older adults with type 2 diabetes and hypertension: a retrospective cohort study2026
  2. 2Triglyceride glucose-body mass index as a practical screening tool for metabolic dysfunction-associated steatotic liver disease in older adults: A community-based cohort study.2026
  3. 3Association of triglyceride glucose-body mass index (TyG-BMI) with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis2025 · 21 citations
  4. 4Triglyceride glucose index—a body shape index (TyG-ABSI) outperforms traditional obesity indices in predicting all-cause and cardiovascular mortality in metabolic-dysfunction associated steatotic liver disease: the mediating role of biological aging2026 · 12 citations
  5. 5Integrating lipometabolic and adiposity indices to enhance risk stratification for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: clinical utility and interplay between triglyceride-glucose body mass index and low-density lipoprotein cholesterol2026 · 1 citations