Markers of insulin resistance associated with non-alcoholic fatty liver disease in non-diabetic population

Abstract

Insulin resistance (IR) plays an important role in the development of non-alcoholic fatty liver disease (NAFLD). IR markers are divided into two types: (1) insulin-based IR marker, homeostatic model assessment of IR (HOMA-IR); and (2) non-insulin-based IR markers, such as triglyceride-glucose (TyG) index, TyG index with body mass index (TyG-BMI), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c), and metabolic score for IR (METS-IR). The non-insulin-based IR markers are often associated with lipids. The aim of this study was to analyse the association between IR markers and NAFLD in non-diabetic population. Baseline data of NAFLD and non-NAFLD groups were compared. Logistic regression was used to evaluate the relationship between five IR markers and NAFLD risk. The odds ratios (ORs) and 95% confidence intervals (CIs) of IR markers were calculated. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the ability of different IR markers to detect NAFLD. Subgroup analyses were performed in obese and non-obese subgroups. This study found a positive correlation between NAFLD risk and elevation in five IR markers (HOMA-IR, TyG, TyG-BMI, TG/HDL-c, and METS-IR). In non-obese subjects, the AUC of TyG-BMI was larger than that of the other four IR markers to detect NAFLD. The AUC of HOMA-IR was larger than that of the other four IR markers to detect NAFLD in obese subjects. In non-diabetic population, the five IR markers are associated with the risk of NAFLD, including non-obese and obese NAFLD. TyG-BMI and HOMA-IR can be used to detect non-obese and obese NAFLD, respectively, with better detection ability compared with the other IR markers.

Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease

“…The association between HOMA-IR and NAFLD has been already reported in previous studies, which found a higher diagnostic value compared to other insulin resistance (IR) markers [ 37 , 38 ]. Similar results were found for LAP; in a meta-analysis involving over 96,000 patients, the pooled sensitivity and specificity of LAP for screening NAFLD were 94% (95% CI 72–99%) and 85% (95% CI 62–96%), respectively [ 39 ].…”

Predicting Non-Alcoholic Steatohepatitis: A Lipidomics-Driven Machine Learning Approach

“…Some of the aforementioned biochemical markers are widely acknowledged as risk factors closely associated with NAFLD, such as HOMA-IR and BMI. In our study, elevated HOMA-IR values were observed in the NASH group, indicating hepatic and adipose tissue IR attributing to NAFLD progression [ 30 , 31 ]. The role of platelets in the progression of NASH has been recognized.…”

The ratio of alanine aminotransferase to high-density lipoprotein cholesterol is positively correlated with the insulin resistance in American adults: a population-based cohort study

“…Based on Model 2, the race, moderate activities, diabetes, SBP, education level, WC, drinking, TC, HbA1c, DBP, serum albumin, eGFR, TG were added as covariates to Model 3. Subgroup analyses stratified by BMI (<30 kg/m2 and ≥ 30 kg/m2), gender (male and female), diabetes (yes and no), age (<50 and ≥ 50 years), moderate activities (yes and no), education level (high school or above and less than high school) and drinking (yes and no) were conducted (19)(20)(21)(22). To examine the potential effect modification within subgroups, interaction terms were employed between subgroup indicators, followed by likelihood ratio tests.…”