THU140 Triglyceride Glucose-body Mass Index Is A Reliable Surrogate Marker To Predict Non-alcoholic Fatty Liver Disease In Children And Adolescents
Authors: Yoon Jong Seo , Yi Kyunghee 
Published: October 2023

Abstract
Disclosure: J. Yoon: None. K. Yi: None.
Background: The triglyceride glucose (TyG) index is significantly associated with the presence of nonalcoholic fatty liver disease (NAFLD) and is a reliable insulin resistance (IR) surrogate marker. TyG index combined with body mass index (BMI) were reported to be superior to TyG index alone in predicting NAFLD in youths. Ultrasound fatty liver indicator (US-FLI) is proposed as a non-invasive, semi-quantitative method for predicting hepatitis in children with NAFLD. Objects: In this study, TyG-BMI detection ability was evaluated in children and adolescents with NAFLD diagnosed by US-FLI and compared with TyG index. We also analyzed the association between TyG-BMI and severity of NAFLD according to the US-FLI scores. Methods: Alanine aminotransferase (ALT) was used as the screening method for NAFLD (&gt;26IU/L in boys and &gt;22IU/L in girls), and US-FLI was performed on children who met these criteria. The US-FLI is a scoring system ranging 2-8 that evaluates based on 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. Healthy children of normal weight (body mass index 5-85th percentile) without metabolic comorbidities and no steatosis on ultrasound participated as a control group. TyG index was calculated as ln(fasting triglyceride (TG) [mg/dL] × fasting glucose [mg/dL]/2), and TyG-BMI were calculated as TyG × BMI. The diagnostic value of TyG-BMI for NAFLD detection was evaluated based on area under the receiver operating characteristic curve (AUC). Results: A total of 130 NAFLD patients (90 boys and 40 girls) included in this study, with mean age of 11.5±2.29 years. The control group consisted of a total of 28 subjects (17 boys and 11 girls) with mean age of 8.39±1.60 years. The TyG-BMI was significantly correlated with AST (r=0.282, p=0.005), ALT (r=0.395, p&lt;0.001), HOMA-IR (r=0.444, p&lt;0.001), and US-FLI (r=0.557, p&lt;0.001) after controlling for sex and age. Multiple linear regression analysis showed that TyG-BMI were significantly associated with ALT (β=0.156, p=0.024), HOMA-IR (β =0.247, p&lt;0.001), US-FLI (β=0.366, p&lt;0.001) after adjusting for confounders. TyG-BMI was independent risk factor for NAFLD (odds ratio: 1.13, 95% confidence interval: 1.041-1.228) after controlling sex and age. In the receiver operating characteristic analysis, the TyG–BMI index (AUC=0.994, p&lt;0.001) showed a better performance for detection of NAFLD than the TyG index (AUC=0.834, p&lt;0.001). Conclusions: TyG-BMI is associated with insulin resistance and severity of US-FLI in NAFLD. In addition, TyG-BMI was superior to TyG index alone in detecting NAFLD. TyG-BMI is expected to be useful in detecting NAFLD and predicting disease progression in children and adolescents.
Presentation: Thursday, June 15, 2023