The triglyceride glucose index: a novel and effective surrogate marker to identify alanine aminotransferase levels

Abstract Introducton: The triglyceride glucose index (TyG) has been proposed as a marker of insulin resistance or type 2 diabetes mellitus (T2DM). Risk of serum alanine aminotransferase (ALT) levels is increased in T2DM patients. We aimed to evaluate the association between TyG index and elevated ALT. Methods: A multicenter, cross-sectional study was conducted in China from Northeast China Rural Cardiovascular Health Study (NCRCHS), and 11,573 adults with complete data were included.Results: TyG index was positively associated with the prevalence of elevated ALT. Frequency of elevated ALT increased from the lowest to the top quartile of TyG in both sexes (p for trend <0.001). Compared with the participants in the lowest quartile of TyG, the adjusted odds ratio and 95% CIs for elevated ALT were 1.71 (1.32-2.21) and 2.46 (1.90-3.19) for those in the third and the fourth quartile of TyG (p<0.001). Compared with the first quartile of TyG, participants in the top quartile of TyG had more than 2 times risk for elevated ALT (2.38-times for men and 2.22-times for women, respectively, p<0.001). According to the ROC analysis, the optimal cut-off point of TyG for elevated ALT was 8.69 and 8.96 for men and women, respectively. Conclusions: TyG index is effective to identify individuals at risk for elevated ALT. TyG thresholds of 8.69 for men and 8.96 for women was highly sensitive for detecting elevated ALT subjects. Findings from this study underscore that TyG index may be suitable as a surrogate marker for abnormal liver enzymes in Chinese adults.