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Life sciences · Journal article
Scientific Reports · September 26, 2026
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Modified triglyceride-glucose (TyG) indices, incorporating body composition markers are considered effective diagnostic indicators of insulin resistance (IR) and metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to compare the diagnostic utility of TyG combined with obesity indices for MASLD-associated metabolic phenotypes in patients with type 2 diabetes. A total of 413 patients with type 2 diabetes mellitus (T2DM) were included in this retrospective observational study. Clinical and biochemical parameters, including anthropometric measures, were collected. Receiver operating characteristic (ROC) analysis, logistic regression, and clustered bar charts were used to analyse the relationships between indicators and MASLD-associated metabolic phenotypes. Among the participants, 67.6% had MASLD, with a higher prevalence in males (72.8%) than in females (60.3%). The MASLD group exhibited significantly higher levels of waist circumference (WC), body mass index (BMI), abdominal visceral fat (AVF), triglycerides (TG), fasting insulin (FINS), fasting plasma glucose (FPG), homeostatic model assessment of insulin resistance (HOMA-IR), TyG, TyG-WC, TyG-BMI, and TyG-AVF compared with the non-MASLD group. The proportion of MASLD cases increased across higher quartiles of TyG, TyG-WC, TyG-BMI, and TyG-AVF. TyG-AVF demonstrated the best diagnostic performance for MASLD-associated metabolic phenotypes, with the highest area under the curve (AUC) values (0.955 overall, 0.950 in males, and 0.953 in females). The most practical diagnostic indicators were TyG-WC for males and TyG-BMI for females. Regression analysis showed that TyG, TyG-BMI, TyG-WC, and TyG-AVF were all associated with MASLD-associated metabolic phenotypes; TyG-AVF exhibited the highest odds ratio after adjustment for other factors. TyG-AVF is a superior diagnostic marker for MASLD-associated metabolic phenotypes in adults with T2DM, outperforming other indices. Males with T2DM are more prone to MASLD-associated metabolic phenotypes than females. TyG-WC in males and TyG-BMI in females serve as simpler alternatives.