Relationship between the glucose-triglyceride frailty index and liver fibrosis: a community-based screening study in China

Currently, few studies conducted in community-based screening populations have investigated the association between the glucose-triglyceride frailty index and liver fibrosis. This study aimed to explore the relationship between the glucose-triglyceride frailty index and liver fibrosis in a community-based screening population. This is a cross-sectional study based on the Lishui Community Liver Health Cohort. The glucose-triglyceride frailty index was stratified by tertiles, and liver fibrosis was assessed by vibration-controlled transient elastography (VCTE). Binary logistic regression analysis was used to evaluate its association with the presence of liver fibrosis. Restricted cubic splines (RCS) were used to explore the linear or nonlinear relationship between TyGFI and liver fibrosis. Further analysis the mediating role of GGT in the association between TyGFI and liver fibrosis risk. After adjusting for potential confounders, participants in the highest TyGFI tertile exhibited a significantly increased risk of liver fibrosis compared to those in the lowest tertile (adjusted OR = 3.28; 95% CI, 2.04–5.30; P < 0.001). Restricted cubic spline (RCS) analysis confirmed a strictly linear dose-response relationship (P for non-linearity = 0.241). This association remained consistent across all prespecified subgroups (P for interaction > 0.05). Furthermore, exploratory mediation analysis suggested that gamma-glutamyl transferase (GGT) partially mediated the association, accounting for 23.43% of the total effect ( P = 0.001). Sex-stratified analysis demonstrated that this potential GGT-mediated statistical association was prominent in males ( P = 0.014), whereas the mediation proportion was not statistically significant in females ( P = 0.70). In community-based screening, TyGFI demonstrates a robust linear dose-response association with the presence of liver fibrosis. An exploratory GGT-mediated statistical link accounts for nearly a quarter of this association, with pronounced male susceptibility. While assessing these factors aids in the sex-tailored identification of individuals with liver fibrosis, utilizing the additive TyG + FI model or TyG alone may be more practical for clinical implementation.