【摘要】 目的 探究甘油三酯-葡萄糖(triglyceride-glucose, TyG)指数对代谢功能障碍相关脂肪肝(metabolic dysfunction-associated steatotic liver disease, MASLD)患者死亡风险的预测价值。方法 基于美国国家健康与营养调查Ⅲ队列获取MASLD患者的资料。采用加权多变量COX比例风险回归模型来估计TyG指数与全因死亡和心血管死亡之间的关联。采用分段COX回归分析探索非线性关系及拐点两侧TyG指数与全因死亡和心血管死亡之间的关联。结果 TyG指数最低至最高四分位数全因死亡的危险比(hazard ratio, HR)分别为1.00、1.01、1.17和1.36,心血管死亡的HR分别为1.00、0.89、1.27和1.83。TyG指数与MASLD患者的全因死亡和心血管死亡呈U型关系。在拐点以上，TyG指数每增加1单位，全因死亡风险增加25%,心血管死亡风险增加46%。结论 TyG指数与MASLD患者的全因死亡和心血管死亡呈U型相关。监测TyG指数有助于评估MASLD患者的死亡风险。更多还原

【Abstract】 Objective To investigate the predictive value of triglyceride-glucose(TyG) for the risk of death in patients with metabolic dysfunction-associated steatotic liver disease(MASLD). Methods Examination data of adult MASLD patients were obtained from the National Health and Nutrition Examination Survey. A weighted multivariate COX proportional risk model was used to estimate the association between TyG index and all-cause mortality and cardiovascular mortality. Segmented COX regression analysis was used to explore nonlinear relationships and associations between TyG index and all-cause mortality and cardiovascular mortality on either side of the inflection point. Results Hazard ratios for all-cause mortality in the lowest to the highest quartiles of the TyG index were 1.00, 1.01, 1.17 and 1.36, respectively. For cardiovascular mortality, hazard ratios were 1.00, 0.89, 1.27 and 1.83, respectively. There was a U-shape relationship between the TyG index and all-cause mortality and cardiovascular mortality in patients with MASLD. Above the inflection point, each one-unit increase in TyG index was associated with a 25% increase in the risk of all-cause mortality and a 46% increase in the risk of cardiovascular mortality. Conclusion TyG index is U-shapedly associated with all-cause mortality and cardiovascular mortality in patients with MASLD. Monitoring the TyG index is useful in assessing the risk of death in patients with MASLD.更多还原