Cardiometabolic risk in non-diabetic metabolic dysfunction-associated steatotic liver disease (MAFLD) patients: insights from the triglyceride-glucose, plasma atherogenic, and cardiometabolic index.

Introduction: The objective of our study was to examine the correlation between hepatosteatosis and the triglyceride-glucose index (TyG), plasma atherogenic index (PAI), and cardiometabolic index (CMI) in nondiabetic patients. We also aimed to assess the usefulness of these indices in evaluating cardiometabolic risk in metabolic dysfunction-associated steatotic liver disease (MAFLD). Material and methods: This retrospective cross-sectional study included 695 individuals who did not have diabetes, with an average age of 39.8 ±11.3 years. A total of 595 individuals, comprising 359 women and 236 men, were diagnosed with MAFLD. The control group consisted of 100 individuals who did not have MAFLD. All the subjects underwent transabdominal ultrasonography, anthropometric measurements, and blood analyses. The groups were assessed based on the TyG index, PAI, and CMI. Results: TyG, PAI, and CMI were greater in patients with MAFLD than those without MAFLD. The TyG index, with a cutoff point of 8.47, excluded significant simple steatosis with a sensitivity of 65.3% and a specificity of 66.0%. The PAI and CMI cutoff values were 0.39 and 1.40, with sensitivities of 66.6% and 70.1% and specificities of 67.0% and 70.1%, respectively. The TyG index was independently associated with MAFLD (OR = 2.21, 95% CI: 1.339-3.665). Conclusions: The presence of MAFLD patients with a normal BMI and waist circumference indicates that these variables alone do not provide enough evidence for the diagnosis of MAFLD. Hence, it is advisable to incorporate the TyG index, the PAI, and the CMI into regular clinical practice to obtain a more precise and thorough evaluation of MAFLD and cardiometabolic risk.