Non-alkolik yağlı karaciğer hastalığında erken aterosklerozun öngörülmesinde trigliserid-glukoz indeksi ve diğer aterojenik indekslerin rolü

Abstract

Amaç Kardiyovasküler risk, non-alkolik yağlı karaciğer hastalığı (NAYKH) olan bireylerde, esas olarak aterosklerozun erken gelişimi nedeniyle belirgin şekilde artmaktadır. Bu araştırmanın temel amacı, trigliserid-glukoz (TyG) indeksi, aterojenik lipid belirteçleri ile bunların NAYKH’de prematür aterosklerozu saptamadaki etkinliği arasındaki ilişkiyi açıklığa kavuşturmaktır. Yöntem Bu retrospektif, kesitsel çalışmaya 80 NAYKH hastası ve 64 sağlıklı kontrol dahil edildi. Demografik, klinik ve biyokimyasal parametreler değerlendirildi. Prematür aterosklerozu tanımlamak için ortalama karotis intima-media kalınlığı (cIMT) ≥0,800 mm eşik değeri kullanıldı. Çeşitli aterojenik indeksler hesaplandı: Castelli risk indeksleri (CRI-1 ve CRI-2), aterojenik katsayı (AC), plazma aterojenik indeksi (AIP) ve TyG indeksi. Gruplar karşılaştırıldıktan sonra, bağımsız yordayıcılar tek değişkenli ve çok değişkenli lojistik regresyon ile belirlendi; tanısal etkinlik ise ROC (Receiver Operating Characteristics) analiziyle değerlendirildi. Tüm analizler SPSS 26.0 kullanılarak yapıldı. Bulgular Prematür ateroskleroz NAYKH grubunda daha sık görüldü (%33,8’e karşı %12,5; p=0,003). Çok değişkenli modellemede, TyG indeksi ve hiperlipidemi (HL), prematür aterosklerozun bağımsız belirleyicileri olarak saptandı. ROC analizi, TyG indeksinin 5,0 kesim değeriyle NAYKH’de prematür aterosklerozu öngörmede orta düzey ayırt edici güce sahip olduğunu gösterdi (duyarlılık %59,3; özgüllük %60,4; AUC=0,687; p=0,007). Sonuç NAYKH hastalarında, TyG indeksi ve hiperlipidemi prematür aterosklerozun bağımsız öngörücüleriydi. Buna karşılık, diğer aterojenik indeksler ve geleneksel kardiyovasküler risk faktörleri ile anlamlı bir ilişki bulunmadı.

Keywords

• erken ateroskleroz
• trigliserid-glukoz indeksi
• kardiyovasküler risk
• aterojenik indeksler
• non-alkolik yağlı karaciğer hastalığı

The role of triglyceride-glucose index and other atherogenic indices in predicting premature atherosclerosis in non-alcoholic fatty liver disease

Abstract

Aims: Cardiovascular risk is significantly heightened in individuals with non-alcoholic fatty liver disease (NAFLD), primarily due to the early development of atherosclerosis. The primary objective of this research was to clarify the association between the triglyceride-glucose (TyG) index, atherogenic lipid markers and their effectiveness in identifying premature atherosclerosis in NAFLD. Methods: This retrospective, cross-sectional study included 80 NAFLD patients and 64 healthy controls. Demographic, clinical and biochemical parameters were evaluated. A mean carotid intima-media thickness (cIMT) threshold of ≥0.800 mm was used to characterize premature atherosclerosis. Several atherogenic indices were calculated, including Castelli risk indices (CRI-1 and CRI-2), atherogenic coefficient (AC), atherogenic index of plasma (AIP) and the TyG index. After comparing the groups, independent predictors were identified through univariate and multivariate logistic regression and the evaluation of diagnostic effectiveness was conducted through the analysis of receiver operating characteristics (ROC). All analyses were performed using SPSS 26.0. Results: Premature atherosclerosis was more frequent in the NAFLD group (33.8% vs. 12.5%, p=0.003). Multivariate modeling revealed TyG index and hyperlipidemia (HL) as independent correlates of premature atherosclerosis. ROC analysis demonstrated that a TyG index cutoff value of 5.0 provided a moderate discriminatory ability for predicting premature atherosclerosis in NAFLD, with a sensitivity of 59.3% and a specificity of 60.4% (AUC=0.687; p=0.007). Conclusion: In NAFLD patients, the TyG index and HL were independent predictors of premature atherosclerosis, whereas other atherogenic indices and conventional cardiovascular risk factors showed no significant association.

Keywords

• Early atherosclerosis
• triglyceride-glucose index
• cardiovascular risk
• atherogenic indices
• nonalcoholic fatty liver disease

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