Simple waist-based metabolic indices may help identify liver risk in type 2 diabetes mellitus (T2DM). A prospective cohort study published in Frontiers in Endocrinology found that triglyceride-glucose waist circumference (TyG-WC) and triglyceride-glucose waist-to-height ratio (TyG-WHtR) were associated with higher long-term risk of liver-related events (LRE) in adults with T2DM.

The analysis included 18,105 participants with T2DM from the UK Biobank. Four triglyceride-glucose (TyG)-based indices were evaluated: TyG, TyG-body mass index (TyG-BMI), TyG-WC, and TyG-WHtR. Cox proportional hazards models and restricted cubic spline analyses were used to assess associations with incident LRE.

Over a median follow-up of 13.4 years, 507 participants developed LRE. Compared with the lowest quartile, the highest quartile of TyG-WC was associated with a 63% higher LRE risk (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.12-2.38), while the highest quartile of TyG-WHtR was associated with nearly doubled risk (HR, 1.98; 95% CI, 1.36-2.89). Linear dose-response relationships were confirmed for both indices. Standard TyG and TyG-BMI were not significantly associated with LRE risk.

Associations were stronger in higher-risk subgroups, including excessive alcohol consumers and those with Fibrosis-4 (FIB-4) scores ≥1.3. These findings suggest TyG-WC and TyG-WHtR may offer practical, low-cost tools to improve liver risk stratification in patients with T2DM.