Abstract: Objective The aim of this study was to explore the clinical implication of serum triglyceride-glucose index (TyG), visceral/subcutaneous fat area ratio (VSR) and cardiac metabolic index (CMI) in elderly patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 98 elderly patients with NAFLD and concomitant T2DM and another 98 elderly patients with NAFLD were enrolled in our hospital between January 2021 and December 2022, and routine biochemical parameters were determined for calculation of TyG and CMI. The VSR was obtained from calculation of body fat detected by special apparatus. The multivariate Logistic regression analysis was applied for risk factor finding. Results The fasting blood glucose, glycosylated hemoglobin, the HOMA-IR and serum triglyceride level in NAFLD patients with T2DM were(9.3±0.7)mmol/L, (9.1±1.6)%, (5.7±0.8) and (3.7±0.5)mmol/L, all significantly higher than [(5.8±0.5)mmol/L, (6.1±1.2)%, (3.9±0.4) and (1.9±0.3)mmol/L, respectively, P<0.05], while serum high-density lipoprotein cholesterol level was (1.2±0.2)mmol/L, significantly lower than [(1.5±0.4)mmol/L, P<0.05] in patients with NAFLD; the TyG, VSR and CMI were (10.8±1.5)%, (0.9±0.2)% and (1.2±0.3)%, all much higher than [(8.7±0.4)%, (0.3±0.1)% and (0.6±0.2)%, respectively, P＜0.05] in patients with NAFLD; the multivariate Logistic regression analysis showed that the TyG(OR=3.124, 95%CI:1.101-8.862), the VSR(OR=2.601, 95%CI:1.035-6.535) and CMI(OR=2.832,95%CI: 1.061-7.561) elevation were all the independent risk factors for T2DM in elderly patients with NAFLD (P＜0.05); the TyG, VSR and CMI in 37 patients with severe NAFLD and concomitant 2DM were (12.4±1.9)%, (1.2±0.3)% and (1.7±0.4)%, all much higher than [(9.7±0.6)%,(0.7±0.1)% and (0.9±0.2)%, respectively, P＜0.05] in 61 patients with mild to moderate NAFLD and T2DM. Conclusion The detection and calculation of relatively simple TyG, VSR and CMI might be help for screening T2DM in elderly patients with NAFLD, and needs further investigation.

Key words: Non-alcoholic fatty liver diseases, Type 2 diabetes mellitus, Triglyceride-glucose index, Visceral/subcutaneous fat area ratio, Cardiac metabolic index