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<p>The association between the triglyceride-glucose-waist-height ratio (TyG-WHtR) and type 2 diabetes mellitus (T2DM) incidence in patients with nonalcoholic fatty liver disease (NAFLD) is not well understood. This study aimed to explore the relationship between TyG-WHtR and T2DM incidence and compared the predictive value of TyG-WHtR with the traditional triglyceride-glucose (TyG) index in this specific population. This prospective cohort study analyzed data from Japanese adults diagnosed with NAFLD participating at Murakami Memorial Hospital between 2004 and 2015. We conducted Kaplan-Meier curves, multivariate Cox regression analysis and restricted cubic splines (RCS) to examine the relationship between TyG-WHtR and other TyG indices with T2DM. The predictive performance was evaluated by using time-dependent receiver operating characteristic (ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses. In addition, subgroup analyses and sensitivity analyses were performed to assess the robustness of the findings. Over a 12-year follow-up period, 223 participants (8.1%) from the cohort of 2737 developed T2DM. Multivariable Cox regression analysis indicated a significant association between TyG-WHtR and T2DM, with a 175% increased risk for each 1-unit rise in TyG-WHtR. Compared to the lowest tertile (T1), participants in tertiles T2 and T3 had hazard ratios (HRs) of 1.28 (95% CI: 0.83–1.98) and 2.7 (95% CI: 1.77–4.12), respectively. The RCS analysis demonstrated a linear positive dose-response association between TyG-WHtR and T2DM incidence, consistent with other TyG-related indices. TyG-WHtR demonstrated enhanced discriminatory ability, as reflected in time-dependent ROC analysis. Additionally, the TyG-WHtR index exhibited a statistically significant improvement in discriminatory accuracy, as quantified by both the NRI and IDI metrics. Sensitivity analyses confirmed that these results were robust. This investigation establishes TyG-WHtR as a novel independent predictor for incident T2DM among individuals with NAFLD. The linear dose-response relationship underscores the potential of TyG-WHtR for early risk assessment and prevention strategies in T2DM.</p>

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Association between triglyceride glucose-waist height ratio index and incidence of type 2 diabetes in patients with nonalcoholic fatty liver disease

  • 期刊论文

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  • 发表日期：

    2026年7月29日

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  • Caizhen Chen,
  • Xiuguo Zhang

摘要

The association between the triglyceride-glucose-waist-height ratio (TyG-WHtR) and type 2 diabetes mellitus (T2DM) incidence in patients with nonalcoholic fatty liver disease (NAFLD) is not well understood. This study aimed to explore the relationship between TyG-WHtR and T2DM incidence and compared the predictive value of TyG-WHtR with the traditional triglyceride-glucose (TyG) index in this specific population. This prospective cohort study analyzed data from Japanese adults diagnosed with NAFLD participating at Murakami Memorial Hospital between 2004 and 2015. We conducted Kaplan-Meier curves, multivariate Cox regression analysis and restricted cubic splines (RCS) to examine the relationship between TyG-WHtR and other TyG indices with T2DM. The predictive performance was evaluated by using time-dependent receiver operating characteristic (ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses. In addition, subgroup analyses and sensitivity analyses were performed to assess the robustness of the findings. Over a 12-year follow-up period, 223 participants (8.1%) from the cohort of 2737 developed T2DM. Multivariable Cox regression analysis indicated a significant association between TyG-WHtR and T2DM, with a 175% increased risk for each 1-unit rise in TyG-WHtR. Compared to the lowest tertile (T1), participants in tertiles T2 and T3 had hazard ratios (HRs) of 1.28 (95% CI: 0.83–1.98) and 2.7 (95% CI: 1.77–4.12), respectively. The RCS analysis demonstrated a linear positive dose-response association between TyG-WHtR and T2DM incidence, consistent with other TyG-related indices. TyG-WHtR demonstrated enhanced discriminatory ability, as reflected in time-dependent ROC analysis. Additionally, the TyG-WHtR index exhibited a statistically significant improvement in discriminatory accuracy, as quantified by both the NRI and IDI metrics. Sensitivity analyses confirmed that these results were robust. This investigation establishes TyG-WHtR as a novel independent predictor for incident T2DM among individuals with NAFLD. The linear dose-response relationship underscores the potential of TyG-WHtR for early risk assessment and prevention strategies in T2DM.