Association between triglyceride–glucose index and liver enzymes in adults with metabolic syndrome: a retrospective cross-sectional study

Background: Previous research has established an association between insulin resistance with alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Studies examining the association between insulin resistance and these enzymes in metabolic syndrome, as determined by the triglyceride–glucose (TyG) index, are scarce. This research aims to investigate the relationship between the TyG index and liver enzyme levels in individuals diagnosed with metabolic syndrome. Materials and methods: This study was conducted in tertiary care hospitals among the Indian adult population aged 20 to 70 who came for regular health checkups at health checkup units from 2021 to 2022. In total, 12112 data were retrieved from the medical record department. After removing the data that didn’t meet our inclusion criteria, 896 participants with metabolic syndrome, 384 females and 512 males, were enrolled. Results: Significant differences in AST, ALT, and ALT/AST ratio were observed across TyG index tertiles (p < 0.05). The TyG index was a statistically significant positive predictor for (AST, β = 0.56; ALT, β = 1.25, and ALT/AST, β = 0.69, with p < 0.001) once correction for age, gender, body mass index, history of diabetes, hypertension, and smoking. Moreover, there was a statistically significant association with several metabolic markers, including total cholesterol, HDL cholesterol, and HbA1C. Conclusion: The TyG index, a simple and inexpensive metric derived from commonly performed laboratory tests, may be a valuable predictor of abnormal liver enzymes (ALT, AST) and their ratio (ALT/AST) in metabolic syndrome patients.