The association of TyG-BMI with MAFLD and liver fibrosis: a cross-sectional study

The early identification and risk stratification of metabolic-associated fatty liver disease (MAFLD) urgently require effective, non-invasive tools. This study aimed to comprehensively evaluate the association of the triglyceride-glucose-body mass index (TyG-BMI) with the risk of MAFLD prevalence and the degree of steatosis, and to further assess its potential as a biomarker for liver fibrosis. This cross-sectional study included 1,457 participants. Logistic regression were employed to assess the association between TyG-BMI and MAFLD risk, with diagnostic performance evaluated by ROC curve analysis. The relationships of TyG-BMI with MAFLD severity and liver stiffness measurement (LSM) were investigated. Individuals with MAFLD had a significantly higher TyG-BMI index than those without (242.02 ± 41.04 vs. 198.44 ± 33.99). After adjusting for confounders, each 1-unit increase in TyG-BMI was associated with a 3.4% increase in the risk of MAFLD (aOR = 1.034, 95% CI: 1.030-1.038). The AUC for TyG-BMI in diagnosing MAFLD was 0.806. This association was significantly modified by age, being stronger in younger individuals (≤ 60 years). Furthermore, trend tests indicated a significant increase in TyG-BMI levels with advancing degree of steatosis, and TyG-BMI was identified as an independent risk factor for the degree of steatosis (OR = 1.033). Additionally, the TyG-BMI index showed a significant positive correlation with LSM (Spearman's r = 0.255). A linear regression confirmed that TyG-BMI was an independent contributing factor to LSM (β = 0.011) after adjusting for age and sex. The TyG-BMI index is independently associated with the prevalence, severity, and fibrosis risk of MAFLD. As a simple, non-invasive index integrating routine metabolic parameters, it holds potential for initial screening and may provide ancillary information for fibrosis risk assessment in clinical practice.