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Objective <p>Hepatic steatosis index (HSI) and triglyceride glucose (TyG) index are emerging markers associated with metabolic health and cardiovascular risk. Their combined effects on cardio-renal outcomes remain poorly understood. This study evaluated the joint effect of HSI and TyG index on cardio-renal outcomes in a real-world population.</p> Methods <p>We analyzed 16,109 participants, stratified by tertiles of TyG index and HSI groups (≤ 36 vs. &gt;36). Cardio-renal outcomes included composite major adverse cardiovascular events (MACE: cerebrovascular events, coronary artery disease, heart failure, myocardial infarction) and renal events (eGFR decline ≥ 50%, end-stage kidney disease [ESKD], proteinuria). Hazard ratios (HRs) were calculated using multivariable Cox proportional hazards models adjusted for demographics and clinical covariates.</p> Results <p>Higher TyG tertiles were associated with a significantly increased risk of composite cardio-renal outcomes (HR for tertile 3 vs. tertile 1: 1.58; 95% CI: 1.37–1.83). Subgroup analysis showed that individuals with HSI &gt; 36 and TyG tertile 3 had the highest risks for composite MACE (HR: 1.62; 95% CI: 1.34–1.96) and composite renal outcomes (HR: 3.13; 95% CI: 2.10–4.68) compared with other subgroups. Both higher TyG and HSI levels showed a particularly strong association with proteinuria (HR for HSI &gt; 36 and TyG tertile 3: 3.69; 95% CI: 2.26–6.02).</p> Conclusions <p>The combined assessment of HSI and TyG index provides a valuable tool for identifying individuals at high risk for cardio-renal outcomes. These findings highlighted the importance of metabolic markers in predicting complications and underscore the need for early interventions targeting these populations.</p>

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Joint effect of hepatic steatosis index and triglyceride glucose index on cardio-renal outcomes: a real-world study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Yun Shen,
  • Lizheng Shi,
  • Vivian Fonseca,
  • Elizabeth Nauman,
  • Eboni Price-Haywood,
  • Gang Hu

摘要

Objective

Hepatic steatosis index (HSI) and triglyceride glucose (TyG) index are emerging markers associated with metabolic health and cardiovascular risk. Their combined effects on cardio-renal outcomes remain poorly understood. This study evaluated the joint effect of HSI and TyG index on cardio-renal outcomes in a real-world population.

Methods

We analyzed 16,109 participants, stratified by tertiles of TyG index and HSI groups (≤ 36 vs. >36). Cardio-renal outcomes included composite major adverse cardiovascular events (MACE: cerebrovascular events, coronary artery disease, heart failure, myocardial infarction) and renal events (eGFR decline ≥ 50%, end-stage kidney disease [ESKD], proteinuria). Hazard ratios (HRs) were calculated using multivariable Cox proportional hazards models adjusted for demographics and clinical covariates.

Results

Higher TyG tertiles were associated with a significantly increased risk of composite cardio-renal outcomes (HR for tertile 3 vs. tertile 1: 1.58; 95% CI: 1.37–1.83). Subgroup analysis showed that individuals with HSI > 36 and TyG tertile 3 had the highest risks for composite MACE (HR: 1.62; 95% CI: 1.34–1.96) and composite renal outcomes (HR: 3.13; 95% CI: 2.10–4.68) compared with other subgroups. Both higher TyG and HSI levels showed a particularly strong association with proteinuria (HR for HSI > 36 and TyG tertile 3: 3.69; 95% CI: 2.26–6.02).

Conclusions

The combined assessment of HSI and TyG index provides a valuable tool for identifying individuals at high risk for cardio-renal outcomes. These findings highlighted the importance of metabolic markers in predicting complications and underscore the need for early interventions targeting these populations.