The role of triglyceride-glucose (TyG)-based indices in predicting liver outcomes in type 2 diabetes mellitus (T2DM) remains under evaluation. A prospective cohort study published in Frontiers in Endocrinology assessed the association between multiple TyG-derived parameters and the risk of liver-related events (LRE) in individuals with T2DM.

The analysis included 18,105 participants with T2DM from the UK Biobank, with a median follow-up of 13.4 years. Four indices were evaluated, including TyG, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist-to-height ratio (TyG-WHtR). Cox proportional hazards models and restricted cubic spline (RCS) analyses were used to examine associations with incident LRE.

During follow-up, 507 participants developed LRE. Compared with the lowest quartile, higher quartiles of TyG-WC and TyG-WHtR were associated with increased LRE risk (hazard ratio [HR] 1.63; 95% confidence interval [CI], 1.12-2.38 and HR 1.98; 95% CI, 1.36–2.89, respectively). No significant associations were observed for TyG or TyG-BMI. RCS analysis showed linear relationships between TyG-WC, TyG-WHtR, and LRE risk.

Subgroup analysis showed stronger associations in individuals with higher baseline risk, including those with Fibrosis-4 (FIB-4) index ≥1.3 and those with higher alcohol consumption. For example, TyG-WHtR showed a higher association with LRE in individuals with FIB-4 ≥1.3 (HR 2.59; 95% CI, 1.65-4.07) compared with those with lower FIB-4.

These findings show that TyG-WC and TyG-WHtR are associated with incident LRE in T2DM, while other TyG-based indices are not. These measures may support risk stratification in clinical settings.