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Cardiovascular

Do TyG and TyG-WHtR predict death and CVD in NAFLD?

Zhang Y, Wang F, Tang J, et al. · Cardiovascular diabetology · 2024

Open access · cc by · source: Europe PMC

In 6,627 NHANES adults with NAFLD, TyG-WHtR better predicted all-cause death, CVD death, and heart failure, while the TyG index tracked total CVD, CHD, and angina.

Study at a glance

Design
Cohort — NHANES 1999–2018 NAFLD adults; Cox models for mortality via NDI and logistic models for prevalent CVD; TyG vs TyG-WHtR quartiles
N
N=6627 · 6,627 adults ≥18 years with NAFLD (USFLI ≥30) from NHANES 1999–2018
Population
US adults with NAFLD in NHANES 1999–2018
Outcome
All-cause mortality, CVD mortality, and prevalent total-CVD, CHF, CHD, and angina

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Key findings

TyG-WHtR predicted all-cause mortality (HR 1.31), CVD mortality (HR 2.22), and CHF (OR 3.99) more strongly than TyG; TyG was stronger for total-CVD (OR 2.00), CHD (OR 1.85), and angina (OR 2.93). Mean TyG was 9.05 and TyG-WHtR 6.03. Adding either index improved C-statistics.

Methodology

Identified NAFLD by USFLI ≥30 in NHANES 1999–2018, computed TyG and TyG-WHtR quartiles, and modeled mortality (Cox/NDI) and self-reported CVD (logistic regression), with RCS curves and mediation by HbA1c, insulin, and hypertension.

Limitations

Observational NHANES data cannot prove TyG causes CVD; NAFLD was index-defined not biopsy-proven, CVD was often self-reported, and findings may not generalize beyond US survey participants.

How this study connects

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