Effect size of the included studies.

BackgroundTyG-BMI has been proposed as a marker of insulin resistance in metabolic-associated fatty liver disease, but its clinical utility remains uncertain. This study aims to evaluate the association between TyG-BMI and metabolic dysfunction-associated steatotic liver disease (MASLD) through a systematic review and meta-analysis, focusing on the diagnostic performance across different subgroups.MethodsA comprehensive literature search was conducted in PubMed, Scopus, Embase, and Web of Science up to January 20, 2025. Studies evaluating the relationship between TyG-BMI and MASLD in adults were included. A random-effects model was employed to pool effect sizes, and subgroup analyses were conducted based on sex, disease definition, and population type.ResultsThirty-five studies with 339,087 participants were included. The pooled mean difference for TyG-BMI between MASLD and non-MASLD groups was 42.72 (95% CI: 35.93–49.51; p ConclusionTyG-BMI is a promising diagnostic marker for MASLD, with higher diagnostic performance in MAFLD and among females. Further studies are needed to confirm these findings in diverse populations.