Lipids & metabolic liver disease
Triglyceride glucose index—a body shape index (triglyceride glucose-a body shape index (TyG-ABSI)) outperforms traditional obesity indices in predicting all-cause and cardiovascular mortality in metabolic-dysfunction associated steatotic liver disease: the mediating role of biological aging
Authors' conclusion
TyG-ABSI serves as a robust, independent predictor of mortality in patients with MASLD, outperforming traditional TyG-related metrics. The association is significantly associated with the pathway of accelerated biological aging, highlighting the utility of TyG-ABSI for enhanced risk stratification in clinical practice.
Study context
- Population
- Adults with MASLD (Fatty Liver Index ≥ 60 plus ≥1 cardiometabolic risk factor), National Health and Nutrition Examination Survey (NHANES) 1999–2018
- Participants
- 7,515 adults
- Exposure
- Highest vs lowest TyG-ABSI quartile
- Outcome
- All-cause mortality (ACM) and cardiovascular mortality (CVM)
- Follow-up
- Median 138 months
Main finding
As reported in the abstract
Each group vs lowest quartileEstimate (95% CI)
Highest TyG-ABSI quartile
HR (ACM) 1.49(1.03–2.14)
Highest TyG-ABSI quartile
HR (CVM) 2.32(1.02–5.30)
- All-cause deaths
- 1368
- Cardiovascular deaths
- 376
Observational data: associations, not effects.
Further findings
Predictive accuracy vs TyG, TyG-BMI, TyG-WC, TyG-WHtR
- TyG-ABSI showed improved predictive accuracy, with higher AUC values and significant NRI
Dose-response and robustness
- Restricted cubic splines (RCS) indicated a linear dose-response relationship; associations robust across subgroup and sensitivity analyses
Mediation by biological aging
- KDM proportion mediated, all-cause mortality (ACM)
- 24.75%
- HD proportion mediated, ACM
- 32.15%
- KDM proportion mediated, cardiovascular mortality (CVM)
- 34.89%
- HD proportion mediated, CVM
- 46.53%
Original publication
Triglyceride glucose index—a body shape index (TyG-ABSI) outperforms traditional obesity indices in predicting all-cause and cardiovascular mortality in metabolic-dysfunction associated steatotic liver disease: the mediating role of biological aging. Cardiovasc Diabetol. Published 22 February 2026. doi:10.
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