{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:40:41Z","timestamp":1776091241998,"version":"3.50.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The triglyceride-glucose (TyG) index is associated with the severity of metabolic-associated fatty liver disease (MASLD), but its link to liver fat content is not fully understood. This study investigates the relationship between the TyG index and liver fat content and explores the role of body mass index (BMI) as a mediator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study analyzed data from 12,750 participants who underwent health screenings at the first affiliated hospital of Xinxiang Medical University between January 2018 and December 2023. The TyG index, derived as Ln [triglycerides (mg\/dl) * fasting plasma glucose (mg\/dl)\/2], was the independent variable, while liver fat content, measured by quantitative computed tomography (QCT), was the dependent variable. Participants were grouped into tertiles based on their TyG index. Univariate and multivariate analyses, smooth curve fitting (generalized additive models), threshold effect analysis, and subgroup analyses were used to assess the TyG-liver fat content relationship. BMI\u2019s mediating effect was also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Liver fat content increased steadily across TyG index tertiles. After adjusting for confounders, the TyG index remained independently associated with liver fat content [\u03b2 = 1.42, 95% CI: 1.26-1.57]. Participants in the highest TyG tertile (T3) had a 1.58-fold higher liver fat content compared to those in the lowest tertile (T1) (95% CI: 1.37-1.80, <jats:italic>P<\/jats:italic>&amp;lt;0.001). A generalized additive model showed a nonlinear relationship between TyG index and liver fat content. When the TyG index \u2264 7.39, liver fat content increased gradually (\u03b2 = 0.74, 95% CI: 0.50-0.99, <jats:italic>P<\/jats:italic>&amp;lt;0.001). Beyond this threshold, liver fat content rose sharply (\u03b2 = 2.19, 95% CI: 1.92-2.46, <jats:italic>P<\/jats:italic>&amp;lt;0.001). Subgroup analysis indicated that the association between TyG index and liver fat content was stronger at higher BMI levels (<jats:italic>P<\/jats:italic> for interaction &amp;lt; 0.001). Mediation analysis revealed that BMI accounted for 26.68% of the observed effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TyG index is positively associated with liver fat content in a nonlinear manner, with BMI amplifying this effect. These results suggest that the TyG index may be a useful marker for predicting liver fat content, and managing weight could help slow the progression of MASLD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1555300","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:12:30Z","timestamp":1745554350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Unraveling the triglyceride-glucose index: a key predictor of liver fat content and the amplifying role of BMI: evidence from a large physical examination data"],"prefix":"10.3389","volume":"16","author":[{"given":"Su-Juan","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Hui","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-Yang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Li","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hua","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Mei","family":"Xue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Yan","family":"Yue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2016.05.003","article-title":"Non-alcoholic fatty liver disease and dyslipidemia: An update","volume":"65","author":"Katsiki","year":"2016","journal-title":"Metabolism: Clin Exp"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204288","article-title":"Quantification of liver fat content with CT and MRI: state of the art","volume":"301","author":"Starekova","year":"2021","journal-title":"Radiology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003","article-title":"Arab JP et\u00a0al: A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"79","author":"Rinella","year":"2023","journal-title":"J hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2024.02.007","article-title":"Current status and future trends of the global burden of MASLD. Trends in endocrinology and metabolism","author":"Miao","year":"2024","journal-title":"Trends Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31150","article-title":"Epidemiological features of NAFLD from 1999 to 2018 in China","volume":"71","author":"Zhou","year":"2020","journal-title":"Hepatol (Baltimore Md)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24021763","article-title":"Can zinc supplementation attenuate high fat diet-induced non-alcoholic fatty liver disease","volume":"24","author":"Bolatimi","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects","volume":"6","author":"Simental-Mend\u00eda","year":"2008","journal-title":"Metab syndrome related Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12933-022-01511-x","article-title":"Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations","volume":"21","author":"Tao","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12933-024-02173-7","article-title":"Wang MS et\u00a0al: Association between different insulin resistance surrogates and all-cause mortality in patients with coronary heart disease and hypertension: NHANES longitudinal cohort study","volume":"23","author":"Hou","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(22)00247-1","article-title":"Gulec S et\u00a0al: Association of the triglyceride glucose index as a measure of insulin resistance with mortality and cardiovascular disease in populations from five continents (PURE study): a prospective cohort study","volume":"4","author":"Lopez-Jaramillo","year":"2023","journal-title":"Lancet Healthy Longevity"},{"key":"B11","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12944-024-02005-3","article-title":"Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis","volume":"23","author":"Behnoush","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.47162\/RJME.62.2.13","article-title":"Triglyceride and glucose index: a useful tool for non-alcoholic liver disease assessed by liver biopsy in patients with metabolic syndrome","volume":"62","author":"Amzolini","year":"2021","journal-title":"Romanian J morphol embryol = Rev roumaine morphologie embryologie"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1321922","article-title":"Association between TyG index trajectory and new-onset lean NAFLD: a longitudinal study","volume":"15","author":"Liu","year":"2024","journal-title":"Front Endocrinol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-023-03335-4","article-title":"The triglycerides and glucose index is highly associated with non-alcoholic fatty liver disease in overweight and obese women","volume":"192","author":"Rodr\u00edguez-Hern\u00e1ndez","year":"2023","journal-title":"Irish J Med Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12933-023-01792-w","article-title":"PNPLA3 rs738409 risk genotype decouples TyG index from HOMA2-IR and intrahepatic lipid content","volume":"22","author":"N\u00e1dasdi","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B16","first-page":"83","article-title":"Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults\u2013study on optimal cut-off points of body mass index and waist circumference in Chinese adults","volume":"15","author":"Zhou","year":"2002","journal-title":"Biomed Environ sciences: BES"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-071952","article-title":"Li X et\u00a0al: Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey","volume":"380","author":"Zhang","year":"2023","journal-title":"BMJ (Clinical Res ed)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1148\/radiol.2019190467","article-title":"Liver fat content measurement with quantitative CT validated against MRI proton density fat fraction: A prospective study of 400 healthy volunteers","volume":"294","author":"Guo","year":"2020","journal-title":"Radiology"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.683743","article-title":"Gut microbiota, glucose, lipid, and water-electrolyte metabolism in children with nonalcoholic fatty liver disease","volume":"11","author":"Pan","year":"2021","journal-title":"Front Cell infection Microbiol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1172\/JCI134165","article-title":"Field T et\u00a0al: Insulin resistance drives hepatic de novo lipogenesis in nonalcoholic fatty liver disease","volume":"130","author":"Smith","year":"2020","journal-title":"J Clin Invest"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.galenos.2024.2024-2-5","article-title":"Triglyceride glucose index is associated with ultrasonographic fatty liver indicator in children and adolescents with non-alcoholic fatty liver disease","volume":"16","author":"Kim","year":"2024","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1186\/s12933-024-02343-7","article-title":"Association between triglyceride-glucose related indices and mortality among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease","volume":"23","author":"Chen","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/nu14234969","article-title":"The diagnostic and prognostic value of the triglyceride-glucose index in metabolic dysfunction-associated fatty liver disease (MAFLD): A systematic review and meta-analysis","volume":"14","author":"Wang","year":"2022","journal-title":"Nutrients"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075413","article-title":"Diagnostic value of triglyceride-glucose index and related parameters in metabolism-associated fatty liver disease in a Chinese population: a cross-sectional study","volume":"13","author":"Yu","year":"2023","journal-title":"BMJ Open"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.04.006","article-title":"Hepatic selective insulin resistance at the intersection of insulin signaling and metabolic dysfunction-associated steatotic liver disease","volume":"36","author":"Bo","year":"2024","journal-title":"Cell Metab"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22084156","article-title":"Role of insulin resistance in MAFLD","volume":"22","author":"Sakurai","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"102581","DOI":"10.1016\/j.dsx.2022.102581","article-title":"Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and Tryglyceride\/glucose index","volume":"16","author":"Tahapary","year":"2022","journal-title":"Diabetes Metab syndrome"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.20960\/nh.04435","article-title":"Association of the triglyceride-glucose index with the occurrence of non-alcoholic fatty liver disease and mortality in elderly inpatients: a prospective observational study","volume":"40","author":"Wang","year":"2023","journal-title":"Nutricion hospitalaria"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1043169","article-title":"The triglyceride and glucose index and risk of nonalcoholic fatty liver disease: A dose-response meta-analysis","volume":"13","author":"Ling","year":"2022","journal-title":"Front Endocrinol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"8974960","DOI":"10.1155\/2023\/8974960","article-title":"Liraglutide attenuates hepatic oxidative stress, inflammation, and apoptosis in streptozotocin-induced diabetic mice by modulating the wnt\/\u03b2-catenin signaling pathway","volume":"2023","author":"Yu","year":"2023","journal-title":"Mediators Inflammation"},{"key":"B31","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1186\/s12944-016-0370-9","article-title":"Melatonin improves non-alcoholic fatty liver disease via MAPK-JNK\/P38 signaling in high-fat-diet-induced obese mice","volume":"15","author":"Sun","year":"2016","journal-title":"Lipids Health Dis"},{"key":"B32","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1743-7075-7-35","article-title":"Recent progress in understanding protein and lipid factors affecting hepatic VLDL assembly and secretion","volume":"7","author":"Sundaram","year":"2010","journal-title":"Nutr Metab"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.993633","article-title":"Spotlight on very-low-density lipoprotein as a driver of cardiometabolic disorders: Implications for disease progression and mechanistic insights","volume":"9","author":"Lee","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1555812","article-title":"Fenugreek seed extract prevents fat deposition in monosodium glutamate (MSG)-obese rats","volume":"66","author":"Kumar","year":"2016","journal-title":"Drug Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.11.038","article-title":"Alterations in adipose tissue and hepatic lipid kinetics in obese men and women with nonalcoholic fatty liver disease","volume":"134","author":"Fabbrini","year":"2008","journal-title":"Gastroenterology"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12071621","article-title":"Noninvasive NMR\/MRS metabolic parameters to evaluate metabolic syndrome in rats","volume":"12","author":"Htun","year":"2022","journal-title":"Diagnostics (Basel Switzerland)"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/metabo12040349","article-title":"N-chlorotaurine reduces the lung and systemic inflammation in LPS-induced pneumonia in high fat diet-induced obese mice","volume":"12","author":"Khanh Hoang","year":"2022","journal-title":"Metabolites"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.862879","article-title":"A novel noninvasive diagnostic model of HBV-related inflammation in chronic hepatitis B virus infection patients with concurrent nonalcoholic fatty liver disease","volume":"9","author":"Tao","year":"2022","journal-title":"Front Med"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.05.011","article-title":"Hepatic glucuronyl C5-epimerase combats obesity by stabilising GDF15","volume":"79","author":"He","year":"2023","journal-title":"J hepatol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1038\/s41467-020-14450-6","article-title":"Liver governs adipose remodelling via extracellular vesicles in response to lipid overload","volume":"11","author":"Zhao","year":"2020","journal-title":"Nat Commun"},{"key":"B41","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s12944-023-01954-5","article-title":"Application value of triglyceride-glucose index and triglyceride-glucose body mass index in evaluating the degree of hepatic steatosis in non-alcoholic fatty liver disease","volume":"22","author":"Wang","year":"2023","journal-title":"Lipids Health Dis"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1555300\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:12:31Z","timestamp":1745554351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1555300\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":41,"alternative-id":["10.3389\/fendo.2025.1555300"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1555300","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]},"article-number":"1555300"}}