Key result
High TyHGB index is linked to ~4-fold higher odds of high ASCVD risk in NAFLD.
Why the study?
Is a higher triglyceride-high-density lipoprotein-glucose-body (TyHGB) index associated with a high 10-year predicted risk of ASCVD in Chinese adults with NAFLD?
Cross-Sectional (n=973)
No
Is a higher triglyceride-high-density lipoprotein-glucose-body (TyHGB) index associated with a high 10-year predicted risk of ASCVD in Chinese adults with NAFLD?
Although the composite TyHGB metabolic index shows a linear, independent positive association with high predicted 10-year ASCVD risk in NAFLD patients, its modest standalone discriminatory performance (AUC 0.607) limits its clinical utility to an exploratory adjunctive marker.
Patients with non-alcoholic fatty liver disease (NAFLD) exhibit heightened susceptibility to atherosclerotic cardiovascular disease (ASCVD), yet whether the triglyceride-high-density lipoprotein-glucose-body (TyHGB) index is associated with high ASCVD risk remains inadequately characterized. This study sought to examine the association between TyHGB and high ASCVD risk in NAFLD patients. This single-center cross-sectional analysis of retrospectively collected data included 973 adults with NAFLD. The TyHGB index was derived from fasting triglyceride, high-density lipoprotein cholesterol, and glucose concentrations. An optimal cutoff for high ASCVD risk classification was determined via receiver operating characteristic (ROC) curve analysis. Multivariable logistic regression models with sequential adjustments were employed to evaluate the TyHGB-high ASCVD risk association. Subgroup analyses and interaction tests were performed to assess effect modification by alcohol use and hypertension. Restricted cubic spline regression was utilized to examine dose-response relationships. ROC analysis identified an optimal TyHGB cutoff of 8.44 for high ASCVD risk discrimination, with a modest area under the curve (AUC) of 0.607 (95% CI: 0.540–0.673), indicating limited discriminatory ability when TyHGB is used alone. In the fully adjusted model (Model 3), TyHGB demonstrated a significant positive association with high ASCVD risk both as a continuous variable (OR = 1.21, 95% CI: 1.08–1.35, P < 0.001) and as a categorical variable (high vs. low: OR = 4.02, 95% CI: 2.13–7.56, P < 0.001). Restricted cubic spline analysis revealed a linear dose-response relationship between TyHGB and ASCVD risk (P for nonlinearity = 0.053). Subgroup analyses identified significant interactions for both alcohol use (P interaction = 0.024) and hypertension (P interaction = 0.041), indicating that the strength of the TyHGB-ASCVD association varied according to these clinical characteristics. TyHGB is associated with high ASCVD risk in NAFLD patients, exhibiting a linear dose-response pattern. However, its discriminatory ability was modest (AUC 0.607), limiting its standalone predictive value. Not applicable.
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Xiong et al. (2026) conducted a cross-sectional in Non-alcoholic fatty liver disease (NAFLD) (n=973). High TyHGB index (>=8.44) vs. Low TyHGB index (<8.44) was evaluated on High 10-year ASCVD risk (score >10% based on 2013 ACC/AHA guidelines) (OR 4.02, 95% CI 2.13-7.56, p=<0.001). High TyHGB index (>=8.44) was associated with four-fold higher odds of high 10-year ASCVD risk in NAFLD patients (adjusted OR 4.02, 95% CI 2.13-7.56, P<0.001), despite modest discrimination (AUC 0.607).
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