The triglycerides and glucose (TyG) index: A new marker associated with nonalcoholic steatohepatitis (NASH) in obese patients

Benjamin Rivière (1) , Audrey Jaussent (1) , Valérie Macioce (1) , Stéphanie Faure (2) , Nicolas Builles (1) , Patrick Lefebvre (1) , Philippe Géraud (1, 3) , Marie-Christine Picot (1, 3) , Sandra Rebuffat (4) , Eric Renard (1, 5, 6) , Valérie Paradis (7) , Marie-Dominique Servais (8) , Nathalie de Preville (8) , David Nocca (9, 6) , Anne-Dominique Lajoix (4) , Georges-Philippe Pageaux (1, 10) , Florence Galtier (3, 4)

1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi]
3 CIC Montpellier
4 BC2M - Biocommunication en Cardio-Métabolique
5 CIC - Montpellier
6 IGF - Institut de Génomique Fonctionnelle
7 Service d’Anatomie Pathologique [CHU Beaujon]
8 Laboratoire Servier
9 Département de chirurgie digestive et transplantation
10 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)

Aim: Diagnosis of nonalcoholic steatohepatitis (NASH) relies on liver biopsy. Noninvasive tools would be useful to target patients to refer for a biopsy. We aimed to determine the diagnostic value of the triglycerides and glucose (TyG) index, an insulin-resistance indicator, to predict NASH. Methods: Our study included grade II-III obese patients aged 18-65 years undergoing bariatric surgery and included in the COMET (COllection of MEtabolic Tissues) biobank (NCT02861781). Liver biopsies performed during bariatric surgery were collected from the biobank along with blood derivatives. Biopsies were analysed according to the steatosis, activity and fibrosis (SAF) scoring system to diagnose NASH, nonalcoholic fatty liver disease (NAFLD), and fibrosis. Logistic regression models were performed to identify factors predicting NASH, NAFLD, and fibrosis. Results: Of 238 analysed subjects (mean age 43±12 years, 33.6% men), 29% had type 2 diabetes. Steatosis was present in 67.2%, while NASH and advanced fibrosis (stage F3) were diagnosed in 18.1% and 2.9% respectively. TyG index was independently associated with NASH (odds ratio (OR): 4.7 [95% confidence interval: 2.3;9.5] P < 0.0001), NAFLD (OR: 2.0 [1.1;3.7] P = 0.03) and stages 2-3 fibrosis (OR: 4.0 [1.5;10.8] P = 0.007). NASH was also predicted by gamma-glutamyl transferase (GGT) with an area under the ROC curve: 0.79 [0.71;0.87 P = 0.04] for GGT and TyG index combined. Conclusion: In our cohort of severely obese patients, TyG index, when associated with GGT level, exhibited high diagnostic performance to predict NASH. Although validation in larger populations is needed, this result may be of considerable clinical value to predict need for liver biopsy.

Mots clés: Fibrosis; Morbid obesity; NAFLD; NASH; TyG

Domaines: Sciences du Vivant [q-bio]

Benjamin Rivière, Audrey Jaussent, Valérie Macioce, Stéphanie Faure, Nicolas Builles, et al.. The triglycerides and glucose (TyG) index: A new marker associated with nonalcoholic steatohepatitis (NASH) in obese patients. Endocrinology, Diabetes & Metabolism, 2022, 48 (4), pp.101345. ⟨10.1016/j.diabet.2022.101345⟩. ⟨hal-03685556⟩