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Liver Disease Diagnosis and Treatment · Journal article
European Journal of Medical Research · September 3, 2026
Encouraging direction, but not yet definitive.
In 7670 HBsAg-positive adults, TyG-WC and TyG-BMI showed the highest and similar discrimination for ultrasound-diagnosed hepatic steatosis (AUC 0.868 vs 0.865), with TyG-WC retaining strong discrimination even in the normal-BMI subgroup (AUC 0.842). The conicity index showed weaker standalone discrimination (AUC 0.749) but a stronger adjusted association in normal-BMI individuals. The source explicitly states that these cross-sectional findings do not establish clinical cutoffs or screening benefit and warrant prospective external validation.
Cross-sectional study with discrimination analysis and pre-specified subgroup stratification. HBsAg-positive adults undergoing routine health examinations; stratified analyses included normal-BMI subgroup (N=3783). Specific age eligibility, exclusion criteria, and geographic setting not detailed in abstract.. Intervention: Measurement of anthropometric indices (conicity index, TyG-WC, TyG-BMI) and lipid-metabolic parameters in HBsAg-positive individuals. Compared with: Ultrasound diagnosis of hepatic steatosis; comparative discrimination of indices via paired DeLong tests. n = 7,670.
Hepatic steatosis identified in 1681 of 7984 participants (21.1%) TyG-WC and TyG-BMI discrimination: AUC 0.868 vs 0.865 (DeLong P = 0.155) Conicity index adjusted OR 1.84 (95% CI 1.64–2.07, per 0.1-unit increase); AUC 0.749
Ultrasound diagnosis of steatosis is a surrogate; no hard clinical outcomes (fibrosis, cirrhosis, mortality) reported.
Clinicians should recognize that TyG-WC and TyG-BMI show superior discrimination for steatosis in HBsAg-positive adults at minimal cost, and perform especially well in normal-BMI individuals where clinical suspicion may be lower. However, the authors explicitly caution that clinical cutoffs and screening benefit remain unestablished; prospective validation is required before these indices should guide clinical decisions or triage protocols.
A sound cross-sectional study in a large, well-characterized HBsAg-positive cohort with rigorous discrimination analysis, but cross-sectional design and surrogate endpoint (ultrasound steatosis) limit the strength; findings require prospective validation before clinical adoption.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that TyG-WC and TyG-BMI show superior discrimination for steatosis in HBsAg-positive adults at minimal cost, and perform especially well in normal-BMI individuals where clinical suspicion may be lower. However, the authors explicitly caution that clinical cutoffs and screening benefit remain unestablished; prospective validation is required before these indices should guide clinical decisions or triage protocols.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Hepatic steatosis commonly coexists with HBsAg positivity, but how low-cost anthropometric and lipid-metabolic indices compare in adjusted cross-sectional association and discrimination, particularly among adults with normal BMI, remains uncertain. We analyzed 7984 HBsAg-positive individuals who underwent routine health examinations between March 2014 and December 2017. Discrimination and incremental model performance were evaluated in a common complete-case sample ( N = 7670; 1634 events) using areas under the receiver operating characteristic curve (AUCs) and paired DeLong tests, with pre-specified subgroup analyses by sex, age group, BMI category, and alanine aminotransferase status. Restricted cubic splines were used to assess nonlinearity for the conicity index, TyG-WC, and TyG-BMI, and 1st/99th percentile winsorization was used to assess sensitivity to extreme values. Hepatic steatosis was identified in 1681 participants (21.1%). The conicity index showed a graded adjusted cross-sectional association with steatosis (extended adjusted OR 1.84, 95% CI 1.64–2.07, per 0.1-unit increase) but lower standalone discrimination (AUC 0.749). TyG-WC and TyG-BMI showed the highest and similar discrimination (AUC 0.868 vs 0.865; DeLong P = 0.155). In the common complete-case sample, adding TyG-WC to age and sex increased the AUC from 0.640 to 0.871. Among 3783 adults with normal BMI, 217 (5.7%) had steatosis; TyG-WC retained an AUC of 0.842, while the conicity index association was stronger than in the overweight and obesity strata (OR 2.26, 95% CI 1.81–2.82, per 0.1-unit increase; P for interaction < 0.001). Spline analyses indicated nonlinearity, whereas the winsorized estimates were similar to the primary estimates. TyG-WC and TyG-BMI showed similar and the highest discrimination for concurrent ultrasound-diagnosed hepatic steatosis in HBsAg-positive adults, including those with normal BMI. The conicity index showed a stronger adjusted cross-sectional association in the normal-BMI stratum but lower standalone discrimination. Because they use routinely collected anthropometric and laboratory measurements, TyG-WC and TyG-BMI warrant prospective external evaluation as low-cost triage aids; however, the present cross-sectional findings do not establish clinical cutoffs or screening benefit.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.