The relationship between triglyceride-glucose index, triglyceride-glucose-body mass index, and the severity of hepatic steatosis and liver fibrosis in patients with MASLD: a cross-sectional study

Objective This study aims to investigate the relationship between the triglyceride-glucose (TyG) index and the triglyceride-glucose-body mass (TyG-BMI) index and the severity of hepatic steatosis and liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), providing more accurate metabolic indicators for non-invasive screening. Methods A retrospective analysis was conducted on 7,035 subjects who completed Fibrotouch testing. Multivariate logistic regression analysis was used to assess the correlation between the TyG index and TyG-BMI index and the severity of hepatic steatosis (mild, moderate, severe) and hepatic fibrosis. Quartile grouping analysis and ROC curve assessment were also used to evaluate predictive performance. Results After adjusting for potential confounding factors, both the TyG index and the TyG-BMI index were significantly positively correlated with the severity of MASLD (both p < 0.001). The association was stronger for TyG-BMI, with the highest quartile (Q4) having a 239.41-fold higher risk of hepatic steatosis compared to the lowest quartile (Q1; OR = 239.41, 95% CI: 170.99–335.21). For liver fibrosis, only TyG-BMI maintained independent association (OR = 1.029, 95% CI: 1.025–1.033). ROC analysis showed that TyG-BMI had significantly better predictive performance for MASLD than TyG (AUC: 0.908 vs. 0.774). Conclusions The TyG-BMI index is a strong predictor of MASLD severity and liver fibrosis, with predictive performance superior to that of the traditional TyG index. It can serve as an effective tool for clinical screening of high-risk populations for MASLD.