{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:13:20Z","timestamp":1787026400268,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"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>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Nonalcoholic fatty liver disease (NAFLD), intricately linked to insulin resistance (IR), obesity, and metabolic syndrome (MetS), affects nearly one-third of the global population. The triglyceride-glucose (TyG) index and its derivative metrics, which integrate anthropometric measures, have emerged as cost-effective tools for assessing IR severity and their associations with NAFLD severity. However, evidence on their association with at-risk nonalcoholic steatohepatitis (NASH), a progressive phenotype characterized by hepatic fibrosis and inflammation, remains limited. This study aimed to evaluate the relationship between TyG related indices and at-risk NASH in a nationally representative NAFLD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the 2017\u20132020 National Health and Nutrition Examination Survey (NHANES), adults with NAFLD diagnosed via vibration-controlled transient elastography (VCTE) were analyzed. At-risk NASH was defined using the FibroScan-AST (FAST) score. Five TyG related indices (TyG, TyG-WC, TyG-WHR, TyG-WtHR, TyG-BMI) were calculated and analyzed through weighted logistic regression, stratified analyses, restricted cubic spline (RCS), and receiver operating characteristic (ROC) analyses. Adjustments included demographics and clinical confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among participants, 10% exhibited at-risk NASH. Composite indices (TyG-WC, TyG-WHR, TyG-WtHR, TyG-BMI) each showed higher ORs than TyG alone in Model 3. TyG-WtHR exhibited the strongest association both as a continuous variable and across tertiles in Model 3, demonstrating a near-linear dose-response relationship. RCS analysis revealed no significant nonlinear relationships in composite indices, whereas the TyG index demonstrated a significant nonlinear association. Stratified analyses revealed elevated risks in males, middle-aged adults, and Non-Hispanic Black individuals. ROC analysis showed the discriminative performance of TyG-WC, while TyG-WtHR balanced sensitivity and specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated significant associations between TyG-related indices and at-risk NASH in NAFLD patients. These non-invasive, cost-effective biomarkers may facilitate for early risk stratification, guiding precision interventions, and optimizing clinical trial design to improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1604991","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:15:09Z","timestamp":1748996109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Association between triglyceride-glucose related indices and at-risk NASH in U.S. adults with NAFLD: results from NHANES 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