Evidence mapPaperPMID 42401883Full record

Observational studyCardiovascular diabetology2026

Comparative performance of insulin resistance-related indices in predicting adverse cardiovascular events among individuals with NAFLD and MASLD: a multi-center cohort study.

Yanqiu Huang, Yadan Xu, Chenghao Zhang, Wen Gu, Yue Li, Haojia Zhang, Tian Wang, Tangyi Su, Yangchen Lhamu, Yichen Chen and 4 more

Abstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Yanqiu Huang *School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yadan Xu *School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chenghao Zhang *School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Wen Gu *School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yue Li *The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China.
Haojia ZhangSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Tian WangSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Tangyi SuSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yangchen LhamuSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yichen ChenPudong New District Center for Disease Control and Prevention of Shanghai, Shanghai, China.
Liang ZhouSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhouliang@shsmu.edu.cn.
Lipeng HaoPudong New District Center for Disease Control and Prevention of Shanghai, Shanghai, China. hlpmail@126.com.
Yang YangSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. yyang93@shsmu.edu.cn.
Hui WangSchool of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China. huiwang@shsmu.edu.cn.

Funding

Medical-Engineering Cross Foundation of Shanghai Jiao Tong University YG2025LC14National Key R&D Program of China 2022YFD2101500National Natural Science Foundation of China 82030099National Natural Science Foundation of China 82403381Noncommunicable Chronic Diseases-National Science and Technology Major Project 2026ZB0556800Sailing Program of Shanghai Rising-Star Program 24YF2722700
6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) and non-alcoholic fatty liver disease (NAFLD) are closely linked to insulin resistance and elevated cardiovascular risk, triglyceride-glucose (TyG)-related indices, the atherogenic index of plasma (AIP), and the cardiometabolic index (CMI) have emerged as practical surrogate markers for cardiometabolic risk assessment in these populations. However, it remains unclear whether the associations of these indices with adverse cardiovascular events remain consistent when transitioning from the NAFLD to the newly defined MASLD framework, and a comprehensive comparison of these indices across both diagnostic criteria is lacking.

methodsThis study included 4693/3266, 74,173/67,864, and 7823/10,576 individuals with MASLD/NAFLD from the National Health and Nutrition Examination Survey (NHANES), UK Biobank (UKB), and China Pudong cohort, respectively. Multivariate Cox proportional hazards models, restricted cubic spline analyses, and time-dependent receiver operating characteristic curves were employed to assess associations. Linear regression models evaluated relationships between TyG-related indices and cortical/subcortical structural volumes. Mediation analyses examined the role of oxidative stress, phenotypic aging, and inflammatory markers.

resultsMost IR-related indices demonstrated nonlinear, predominantly J-shaped associations with cardiovascular disease (CVD) and related mortality, especially within the UKB. TyG-WC optimally predicted 3-year CVD mortality in MASLD/NAFLD across UKB and NHANES, as well as ischemic stroke (IS) in UKB-MASLD. TyG-WHTR was the strongest predictor for CVD mortality in the Pudong cohort and myocardial infarction (MI) in UKB-MASLD. Notably, elevated TyG-WHTR was consistently associated with heightened risks across all endpoints: CVD mortality (NAFLD: UKB: HR 1.60, 95%CI 1.38-1.84, NHANES: 1.90, 1.34-2.70, Pudong: 1.24, 1.10-1.40; MASLD: UKB: 1.59, 1.38-1.82, NHANES: 1.86, 1.36-2.54, Pudong: 1.70, 1.43-2.03), MI (NAFLD: 1.20, 1.09-1.33; MASLD: 1.22, 1.11-1.34), and IS (NAFLD: 1.41, 1.24-1.61; MASLD: 1.39, 1.23-1.57). Structural neuroimaging analyses revealed significant negative correlations between TyG-WC/TyG-WHTR and subcortical volumes (P < 1 × 10

conclusionsInsulin Resistance-Related Indices demonstrate robust clinical utility in predicting CVD and mortality in NAFLD/MASLD across three distinct cohorts, with oxidative stress, inflammatory activation, and accelerated aging serving as potential mechanistic pathways.

Indexed as

Blood GlucoseCardiovascular DiseasesInsulin ResistanceMetabolic SyndromeNon-alcoholic Fatty Liver DiseaseAdultAgedBiomarkersCardiometabolic Risk FactorsChinaFemaleHumansInflammation MediatorsMaleMiddle AgedNutrition SurveysBiomarkersBlood GlucoseInflammation MediatorsTriglyceridesAdverse cardiovascular eventsAtherogenic index of plasmaCardiometabolic indexCohort studyMetabolic dysfunction-associated steatotic liver diseaseNon-alcoholic fatty liver diseaseTriglyceride-glucose index

Identifiers

PMID42401883
PMCPMC13335360

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.