ESPE Abstracts

Background: Insulin resistance, non-alcoholic fatty liver disease (NAFLD), and metabolic syndrome (MetS) are strongly correlated with each other. Triglyceride and glucose (TyG) index, a simple and useful insulin resistance surrogate marker, has recently been reported to be superior in predicting NAFLD in adults.

Objects: We evaluated the usefulness of TyG–alanine aminotransferase (ALT) for detecting NAFLD and compared to it to that of the TyG index and homeostatic model assessment for insulin resistance (HOMA-IR).

Methods: We enrolled 4,055 participants aged 10–18 years from the Korea National Health and Nutrition Examination Survey. Multivariable linear regression analysis was used to analyze the association between liver enzymes and insulin resistance surrogate markers. The TyG index and TyG-ALT were calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] and [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) x ALT/2], respectively.

Results: Multiple linear regression analysis revealed that ALT levels were significantly associated with HOMA-IR (β=0.111, P<0.001), the TyG index (β=0.111, P<0.001), the TyG–body mass index (BMI) standard deviation score (SDS) index (β=0.310, P<0.001), and the TyG–ALT index (β=0.551, P<0.001) after controlling for sex, age, and BMI SDS. In the receiver operating characteristic analysis, the TyG–ALT index (area under the curve [AUC]=0.939) showed a better performance than HOMA-IR (AUC=0.707), the TyG index (AUC=0.667), and the TyG–BMI SDS index (AUC=0.786) for NAFLD detection (P<0.001).

Conclusions: The TyG–ALT index is a more useful marker for NAFLD detection than HOMA-IR, the TyG index, and the TyG–BMI SDS index in children and adolescents. Further studies are needed to determine its potential role as a noninvasive method for NAFLD screening.