Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 4/2024

01-03-2024 | Overweight | Original Contributions

TyG-GGT is a Reliable Non-Invasive Predictor of Advanced Liver Fibrosis in Overweight or Obese Individuals

Authors: Lei Jin, Jing Gu, Zhe Zhang, Cheng-Fei Du, Fei-Qi Xu, Xiao-Kun Huang, Zhen-Yu Gao, Ying Li, Li-Li Yu, Xin Zhang, Guo-Qing Ru, Jun-Wei Liu, Lei Liang, Xiao-Dong Sun, Zun-Qiang Xiao

Published in: Obesity Surgery | Issue 4/2024

Login to get access

Abstract

Background

Liver fibrosis is a predisposing factor for liver cancer. This study will investigate the predictive role of the Triglyceride-glucose and Gamma-glutamyl transferase index (TyG-GGT) as a non-invasive indicator of advanced liver fibrosis in individuals with obesity or overweight.

Method

We enrolled patients who underwent metabolic and bariatric surgery as well as intraoperative liver biopsies at Zhejiang provincial people's hospital from August 2020 to March 2023. Clinical characteristics, comorbidities, laboratory data, and pathological variables of patients were collected and analysed. Then, we conducted logistics regression model to compare the performance of the TyG-GGT index with other 4 non-invasive models.

Results

A total of 65 patients were included in this study. 43(66.2%) of them were female, with the mean body mass index (BMI) of 39.0 ± 7.3 kg/m2. Meanwhile, 24(36.9%) patients were diagnosed with diabetes. Advanced liver fibrosis were observed in 16.9% of patients, while liver cirrhosis was found in 4.6% of patients. The multivariable logistics regression showed that TyG-GGT was an independent risk factor of advanced liver fibrosis (OR = 6.989, P = 0.049). Additionally, compared to another 4 non-invasive liver fibrosis models (NFS = 0.66, FIB4 = 0.65, METS-IR = 0.68, APRI = 0.65), TyG-GGT exhibits the highest AUC value of 0.75.

Conclusions

More than one-third of patients undergoing metabolic and bariatric surgery are afflicted with nonalcoholic steatohepatitis (NASH), and a significant proportion exhibit advanced fibrosis. TyG-GGT was a potentially reliable predictor for screening individuals with overweight or obesity at high risk of advanced liver fibrosis, thus providing clinical guidance for early intervention in this targeted group.

Graphical Abstract

Literature
1.
Brown ZJ, Tsilimigras DI, Ruff SM, et al. Management of hepatocellular carcinoma: a review. JAMA Surg. 2023;158(4):410–20.CrossRefPubMed
2.
Gui R, Li W, Li Z, et al. Effects and potential mechanisms of IGF1/IGF1R in the liver fibrosis: A review. Int J Biol Macromol. 2023;9(251):126263.CrossRef
3.
Ekstedt M, Hagström H, Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61(5):1547–54.CrossRefPubMed
4.
5.
Loomba R, Sanyal AJ. The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol. 2013;10(11):686–90.CrossRefPubMed
6.
Li J, Zou B, Yeo YH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4(5):389–98.CrossRefPubMed
7.
8.
Sheka AC, Adeyi O, Thompson J, et al. Nonalcoholic steatohepatitis: a review. JAMA. 2020;323(12):1175–83.CrossRefPubMed
9.
Katsagoni CN, Georgoulis M, Papatheodoridis GV, et al. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: A meta-analysis. Metabolism. 2017;68:119–32.CrossRefPubMed
10.
Castera L, Friedrich-Rust M, Loomba R. Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology. 2019;156(5):1264-1281.e4.CrossRefPubMed
11.
Kjaergaard M, Lindvig KP, Thorhauge KH, et al. Using the ELF test, FIB-4 and NAFLD fibrosis score to screen the population for liver disease. J Hepatol. 2023;79(2):277–86.CrossRefPubMed
12.
Amernia B, Moosavy SH, Banookh F, et al. FIB-4, APRI, and AST/ALT ratio compared to FibroScan for the assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease in Bandar Abbas. Iran BMC Gastroenterol. 2021;21(1):453.CrossRefPubMed
13.
Sandvik ECS, Aasarød KM, Johnsen G, et al. The effect of roux-en-Y gastric bypass on non-alcoholic fatty liver disease fibrosis assessed by FIB-4 and NFS scores-An 11.6-year follow-up study. J Clin Med. 2022;11(16):4910.CrossRefPubMedPubMedCentral
14.
Lee JH, Park K, Lee HS, et al. The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults. Clin Mol Hepatol. 2022;28(4):814–26.CrossRefPubMedPubMedCentral
15.
Zhang S, Du T, Li M, et al. Triglyceride glucose-body mass index is effective in identifying nonalcoholic fatty liver disease in nonobese subjects. Medicine (Baltimore). 2017;96(22):e7041.CrossRefPubMed
16.
Guo W, Lu J, Qin P, et al. The triglyceride-glucose index is associated with the severity of hepatic steatosis and the presence of liver fibrosis in non-alcoholic fatty liver disease: a cross-sectional study in Chinese adults. Lipids Health Dis. 2020;19(1):218.CrossRefPubMedPubMedCentral
17.
Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism. 2016;65(8):1038–48.CrossRefPubMed
18.
Rivière B, Jaussent A, Macioce V, et al. The triglycerides and glucose (TyG) index: A new marker associated with nonalcoholic steatohepatitis (NASH) in obese patients. Diabetes Metab. 2022;48(4):101345.CrossRefPubMed
19.
Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–21.CrossRefPubMed
20.
Brunt EM, Kleiner DE, Wilson LA, et al. Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings. Hepatology. 2011;53(3):810–20.CrossRefPubMed
21.
Kleiner DE, Brunt EM, Wilson LA, et al. Association of histologic disease activity with progression of nonalcoholic fatty liver disease. JAMA Netw Open. 2019;2(10):e1912565.CrossRefPubMedPubMedCentral
22.
Wong VW, Ekstedt M, Wong GL, et al. Changing epidemiology, global trends and implications for outcomes of NAFLD. J Hepatol. 2023;79(3):842–52.CrossRefPubMed
23.
Kumar S, Duan Q, Wu R, et al. Pathophysiological communication between hepatocytes and non-parenchymal cells in liver injury from NAFLD to liver fibrosis. Adv Drug Deliv Rev. 2021;176:113869.CrossRefPubMed
24.
Quek J, Chan KE, Wong ZY, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20–30.CrossRefPubMed
25.
Simon TG, Roelstraete B, Sharma R, et al. Cancer risk in patients with biopsy-confirmed nonalcoholic fatty liver disease: a population-based cohort study. Hepatology. 2021;74(5):2410–23.CrossRefPubMed
26.
Kennedy P, Wagner M, Castéra L, et al. Quantitative elastography methods in liver disease: current evidence and future directions. Radiology. 2018;286(3):738–63.CrossRefPubMed
27.
Yu JH, Lee HA, Kim SU. Noninvasive imaging biomarkers for liver fibrosis in nonalcoholic fatty liver disease: current and future. Clin Mol Hepatol. 2023;29(Suppl):S136–49.CrossRefPubMed
28.
Pais R, Aron-Wisnewsky J, Bedossa P, et al. Persistence of severe liver fibrosis despite substantial weight loss with bariatric surgery. Hepatology. 2022;76(2):456–68.CrossRefPubMed
29.
Huang Y, Dong S, Wang C, et al. Significant fibrosis assessed by liver biopsy among Chinese bariatric surgery patients: A prospective cross-sectional study. Front Endocrinol (Lausanne). 2023;30(14):1090598.CrossRef
30.
Ajmera V, Cepin S, Tesfai K, et al. A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes. J Hepatol. 2023;78(3):471–8.CrossRefPubMed
31.
Alexander M, Loomis AK, van der Lei J, et al. Risks and clinical predictors of cirrhosis and hepatocellular carcinoma diagnoses in adults with diagnosed NAFLD: real-world study of 18 million patients in four European cohorts. BMC Med. 2019;17(1):95.CrossRefPubMedPubMedCentral
32.
Sako S, Takeshita Y, Takayama H, et al. Trajectories of liver fibrosis and gene expression profiles in nonalcoholic fatty liver disease associated with diabetes. Diabetes. 2023;72(9):1297–306.CrossRefPubMed
33.
Lee SH, Park SY, Choi CS. Insulin resistance: from mechanisms to therapeutic strategies. Diabetes Metab J. 2022;46(1):15–37.CrossRefPubMed
34.
Angulo P, Machado MV, Diehl AM. Fibrosis in nonalcoholic Fatty liver disease: mechanisms and clinical implications. Semin Liver Dis. 2015;35(2):132–45.CrossRefPubMed
35.
Fritz J, Bjørge T, Nagel G, et al. The triglyceride-glucose index as a measure of insulin resistance and risk of obesity-related cancers. Int J Epidemiol. 2020;49(1):193–204.CrossRefPubMed
36.
Lonardo A, Lombardini S, Scaglioni F, et al. Hepatic steatosis and insulin resistance: does etiology make a difference? J Hepatol. 2006;44(1):190–6.CrossRefPubMed
37.
Zeng DW, Huang ZX, Lin MX, et al. A novel HBsAg-based model for predicting significant liver fibrosis among Chinese patients with immune-tolerant phase chronic hepatitis B: a multicenter retrospective study. Therap Adv Gastroenterol. 2021;29(14):17562848211010676.
Metadata
Title
TyG-GGT is a Reliable Non-Invasive Predictor of Advanced Liver Fibrosis in Overweight or Obese Individuals
Authors
Lei Jin
Jing Gu
Zhe Zhang
Cheng-Fei Du
Fei-Qi Xu
Xiao-Kun Huang
Zhen-Yu Gao
Ying Li
Li-Li Yu
Xin Zhang
Guo-Qing Ru
Jun-Wei Liu
Lei Liang
Xiao-Dong Sun
Zun-Qiang Xiao
Publication date
01-03-2024
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07139-y

Other articles of this Issue 4/2024

Obesity Surgery 4/2024 Go to the issue

Original Contributions

Bariatric Surgery Outcomes in Patients with Inflammatory Bowel Disease in the United States: An Analysis of the Nationwide Readmissions Database

Original Contributions

Convincing 10-Year Follow-up Results of the Banded Roux-en-Y Gastric Bypass

Original Contributions

Factors Associated with Statin Discontinuation Following Metabolic and Bariatric Surgery: A Retrospective Analysis of 2012–2021 Electronic Medical Records Network Data

Original Contributions

Sleeve Gastrectomy Reduces the Need for Liver Transplantation in Patients with Obesity and Non-Alcoholic Steatohepatitis: a Predictive Model

Correction

Correction: Concurrent Hiatus Hernia Repair with Bariatric Surgery

Original Contributions

Effects of Probiotic Use on Gastrointestinal Symptoms in the Late Postoperative Period of Bariatric Surgery: A Cross-Over, Randomized, Triple-Blind, Placebo-Controlled Study