ESPE Abstracts

Background: Triglyceride glucose (TyG) index is known as a reliable insulin resistance surrogate marker to identify non-alcoholic fatty liver disease (NAFLD). Ultrasound fatty liver indicator (US-FLI) is proposed as a non-invasive, semi-quantitative method for predicting hepatitis in children with NAFLD and may reflect the severity of liver histological changes. US-FLI ≥4 has been suggested as a predictive finding for severe NASH. US-FLI correlates significantly with metabolic disorders and can predict insulin resistance.

Objects: This study evaluated the relationship between US-FLI and TyG index in pediatric NAFLD and compare it with homeostatic model assessment for insulin resistance (HOMA-IR).

Methods: A cross sectional study was performed in 87 participants with mean age of 11.42±2.19 years diagnosed with fatty liver on ultrasound. US-FLI is a new scoring system ranging 2-8 based on the intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focal sparing. NAFLD is diagnosed by the minimum score ≥2. Anthropometric and biochemical measurements were evaluated. TyG index was calculated as ln(fasting triglyceride (TG) [mg/dL] × fasting glucose [mg/dL]/2).

Results: The US-FLI was significantly correlated with BMI (r=0.288, p=0.007), BMI SDS (r=0.245, p=0.022), glucose (r=0.372, p=0.001), AST (r=0.255, p=0.017), ALT (r=0.301, p=0.005) and TyG index (r=0.311, p=0.006), and not with HOMA-IR (r=0.194, p=0.127). In multivariate logistic linear regression analysis, TyG index was an independent risk factor for severe NASH diagnosed by US-FLI (OR 4.032; P=0.009), but HOMA-IR was not statistically significant as a risk factor (OR 1.154; P=0.146).

Conclusions: The TyG index was significantly associated with US-FLI than HOMA-IR and may reflect the severity of NAFLD associated with insulin resistance. Therefore, the TyG index and US-FLI may be useful as non-invasive methods to monitor the severity of NAFLD in children and further studies are needed.