The Effect of the TyG Index on Liver Steatosis, Immune Activation, Oxidative Stress, Liver Fibrosis Pathways and Liver Fibrosis in the Miami Adult Studies on HIV (MASH) Cohort

The purpose of this study was to establish the Triglyceride-Glucose (TyG) Index Ln (fasting TG x fasting glucose/2) as a predictor of liver steatosis in People Living with HIV (PLWH) and determine the effect of increased TyG Index on biomarkers of immune activation, inflammation, oxidative stress, apoptosis, and liver fibrosis. Four-hundred and eighty participants were selected from the Miami Adult Studies on HIV (MASH) cohort, two-hundred and eleven were PLWH, and two-hundred and sixty-nine were uninfected controls. Biomarkers were analyzed from blood samples collected at the FIU Borinquen Clinic. Primary research outcomes were analyzed using multiple linear and logistic regression, pairwise analyses, and ROC curves. The TyG Index was determined to be a good predictor of liver steatosis among PLWH and uninfected controls (AUC=0.738 and AUC=0.702), respectively. Participants in the High TyG Risk category were 4.638 times more likely to have liver steatosis than those in the Low TyG Risk category [95% CI:(2.075, 10.368)]. Greater TyG Index was associated with higher immune activation markers Ln sCD14 (β=0.080, P=0.050) and Ln sCD163 (β=0.164, P=0.008). Linear regression analysis found HIV infection to be associated with higher levels sCD27 (β=0.181, P=0.005), and liver fibrosis pathway biomarkers LnTGF- β (β=0.915, P These data indicate a consistent relationship between increased TyG Index and biological pathways that lead to liver fibrosis. As liver disease becomes a more prominent concern among PLWH, it is crucial for health care professionals to address markers of metabolic health, such as the TyG Index, as a means to effectively manage liver steatosis and avoid the development of liver fibrosis