{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:59:05Z","timestamp":1790787545916,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"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>Background<\/jats:title>\n                    <jats:p>Accumulating evidence has linked the triglyceride-glucose (TyG) index and its derived measures to a broad range of diabetic complications. However, the nature of the association between these indices and subsequent liver morbidity in type 2 diabetes (T2D) patients warrants further investigation. The present analysis assessed the prospective associations between four TyG-based parameters and the incidence of liver-related events (LRE) among people with T2D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 18,105 participants with T2D from the UK Biobank. Four TyG-related indices were assessed, including TyG, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR). Cox proportional hazards models and restricted cubic spline (RCS) were used to evaluate the associations between TyG-related indices and incident LRE risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 13.4 years, 507 T2D patients developed LRE. Compared to patients in the lowest quartile, those in the highest quartiles of both TyG-WC (HR\u00a0=\u00a01.63, 95% CI 1.12-2.38) and TyG-WHtR (HR\u00a0=\u00a01.98, 95% CI 1.36-2.89) were associated with increased risk of LRE. Restricted cubic spline models confirmed linear relationships for both TyG-WC and TyG-WHtR with LRE risk. No significant associations of TyG and TyG-BMI with LRE risk were observed. Subgroup analyses demonstrated that the associations between TyG-WC\/TyG-WHtR and LRE were more pronounced in high-risk populations, including excessive alcohol consumers and individuals with FIB-4 scores \u22651.3 (indicating higher liver fibrosis risk). For instance, the association between TyG-WHtR and LRE was stronger in individuals with FIB-4 \u22651.3 (HR\u00a0=\u00a02.59, 95% CI 1.65-4.07) compared to those with FIB-4 &amp;lt;1.3 (HR\u00a0=\u00a01.58, 95% CI 0.76-3.29).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among T2D patients, TyG-WC and TyG-WHtR were consistently associated with increased risk of LRE, confirming the independent clinical utility of these indices. These findings demonstrate that both indices may serve as efficient, cost-effective, and practical tools for enhancing the identification and stratification of LRE risk in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1760656","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:38:09Z","timestamp":1776832689000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between triglyceride-glucose-related indices and liver-related events in patients with type 2 diabetes"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanan","family":"Mi","sequence":"first","affiliation":[{"name":"Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]},{"name":"School of Public Health, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenhao","family":"Ye","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deji","family":"Song","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Chao","sequence":"additional","affiliation":[{"name":"Comprehensive Supervision and Law Enforcement Bureau, Shibei District Health Bureau","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qian","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for\u00a0the Global Burden of Disease Study 2017","volume":"5","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2020.07.017","article-title":"Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival","volume":"187","author":"Innes","year":"2020","journal-title":"Public Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5085(24)04333-6","article-title":"Missed and delayed diagnoses of chronic liver disease in primary care patients with cirrhosis","volume":"69","author":"Patel","year":"2024","journal-title":"Digestive Dis Sci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1159\/000539371","article-title":"Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)","volume":"81","year":"2024","journal-title":"J Hepatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000000323","article-title":"AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease","volume":"77","author":"Rinella","year":"2023","journal-title":"Hepatol (Baltimore Md)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.07.049","article-title":"Clinical care pathway for the risk stratification and management of patients with nonalcoholic fatty liver disease","volume":"161","author":"Kanwal","year":"2021","journal-title":"Gastroenterology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1016\/j.cgh.2021.12.034","article-title":"Low accuracy of FIB-4 and NAFLD fibrosis scores for screening for liver fibrosis in the population","volume":"20","author":"Graupera","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/j.cgh.2022.05.015","article-title":"Poor diagnostic efficacy of noninvasive tests for advanced fibrosis in obese or younger than 60 diabetic NAFLD patients","volume":"21","author":"Ito","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/goaf028","article-title":"Prediction of major liver-related events in the population using prognostic models","volume":"13","author":"\u00c5berg","year":"2025","journal-title":"Gastroenterol Rep"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000001400","article-title":"Detecting at-risk steatotic liver disease and liver fibrosis in the community","author":"Adams","year":"2025","journal-title":"Hepatol (Baltimore Md)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2522972","article-title":"Association between triglyceride-glucose index and liver enzymes in adults with metabolic syndrome: a retrospective cross-sectional study","volume":"57","author":"Rana","year":"2025","journal-title":"Ann Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1604991","article-title":"Association between triglyceride-glucose related indices and at-risk NASH in U.S. adults with NAFLD: results from NHANES 2017-2020","volume":"16","author":"Ma","year":"2025","journal-title":"Front Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"15695","DOI":"10.1038\/s41598-025-01003-4","article-title":"Association of cardiometabolic markers with hepatic steatosis and liver fibrosis in population without obesity and diabetes","volume":"15","author":"Fan","year":"2025","journal-title":"Sci Rep"},{"key":"B14","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1186\/s12933-025-02716-6","article-title":"Associations between cardiometabolic indices and the onset of metabolic dysfunction-associated steatotic liver disease as well as its progression to liver fibrosis: a cohort study","volume":"24","author":"Song","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1186\/s12933-025-02914-2","article-title":"The triglyceride-glucose index: updating evidence from clinical settings to molecular mechanisms in ageing-related cerebrovascular diseases","volume":"24","author":"Tang","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2025.04.003","article-title":"The liver in diabetes and metabolic syndrome","volume":"29","author":"Mahmoud","year":"2025","journal-title":"Clinics Liver Dis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0162388","article-title":"Algorithms for the capture and adjudication of prevalent and incident diabetes in UK Biobank","volume":"11","author":"Eastwood","year":"2016","journal-title":"PloS One"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02572-w","article-title":"Association between triglyceride-glucose (TyG) related indices and cardiovascular diseases and mortality among individuals with metabolic dysfunction-associated steatotic liver disease: a cohort study of UK Biobank","volume":"24","author":"Qiao","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatol (Baltimore Md)"},{"key":"B20","article-title":"World Obesity Atlas 2025","year":"2025"},{"key":"B21","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1186\/s12933-025-02909-z","article-title":"Planetary health diet, other plant-based diets and risk of type 2 diabetes: a prospective study from the UK Biobank","volume":"24","author":"Aznar de la Riera","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12933-025-02622-x","article-title":"Association of baseline and trajectory of triglyceride-glucose index with the incidence of cardiovascular autonomic neuropathy in type 2 diabetes mellitus","volume":"24","author":"Huang","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1186\/s12933-025-02890-7","article-title":"Does diabetes status modify the association between the triglyceride-glucose index and major adverse cardiovascular events in patients with coronary heart disease? A systematic review and meta-analysis of longitudinal cohort studies","volume":"24","author":"Xu","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s12933-025-02671-2","article-title":"Triglyceride glucose index predicts long-term mortality and major adverse cardiovascular events in patients with type 2 diabetes","volume":"24","author":"Sbriscia","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1186\/s12933-024-02446-1","article-title":"Multiple triglyceride-derived metabolic indices and incident cardiovascular outcomes in patients with type 2 diabetes and coronary heart disease","volume":"23","author":"Tao","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2025.120407","article-title":"Impact of baseline and trajectory of the cardiometabolic indices on incident microvascular complications in patients with type 2 diabetes","volume":"407","author":"Cao","year":"2025","journal-title":"Atherosclerosis"},{"key":"B27","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1186\/s12933-024-02392-y","article-title":"Diagnostic and prognostic value of triglyceride glucose index: a comprehensive evaluation of meta-analysis","volume":"23","author":"Nayak","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-025-10792-9","article-title":"A robust diagnostic model for high-risk MASH: integrating clinical parameters and circulating biomarkers through a multi-omics approach","volume":"19","author":"Zhang","year":"2025","journal-title":"Hepatol Int"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1594548","article-title":"Study on the correlation between triglyceride glucose index, triglyceride glucose index to high-density lipoprotein cholesterol ratio, and the risk of diabetes in nonalcoholic fatty liver disease","volume":"16","author":"Sun","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.01.010","article-title":"Diabetes liver fibrosis score to detect advanced fibrosis in diabetics with nonalcoholic fatty liver disease","volume":"20","author":"Singh","year":"2022","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1760656\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:38:13Z","timestamp":1776832693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1760656\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":30,"alternative-id":["10.3389\/fendo.2026.1760656"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1760656","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1760656"}}