Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020
IntroductionNon-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, with liver fibrosis (LF) being a crucial pathological feature in the progression of NAFLD. Insulin resistance (IR) is believed to play an important role in the pathogenesis of NAFLD and the d...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1514093/full |
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| author | Bo Yang Mingsu Gong Xiaojie Zhu Yang Luo Ruiqiu Li Hai Meng Yuhan Wang |
| author_facet | Bo Yang Mingsu Gong Xiaojie Zhu Yang Luo Ruiqiu Li Hai Meng Yuhan Wang |
| author_sort | Bo Yang |
| collection | DOAJ |
| description | IntroductionNon-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, with liver fibrosis (LF) being a crucial pathological feature in the progression of NAFLD. Insulin resistance (IR) is believed to play an important role in the pathogenesis of NAFLD and the development of LF. This study aims to explore the relationship between various IR indicators and LF in patients with NAFLD.MethodsThis study utilized data from the National Health and Nutrition Examination Survey 2017-2020 cycles. Liver steatosis and fibrosis were assessed using liver ultrasound transient elastography. To assess the association between multiple IR indicators and LF, the study methodology included univariate and multivariate logistic regression, as well as restricted cubic spline (RCS) analysis. Subsequently, we used multivariate logistic regression to develop and validate a predictive model for LF, and evaluated the model’s performance using the area under the curve (AUC) and calibration curve.ResultsA total of 904 patients were included in the final analysis. Among these NAFLD patients, 153 (16.92%) had LF. Compared to non-LF patients, LF patients had significantly higher body mass index (BMI), waist circumference (WC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), HbA1c, and fasting blood glucose (FBG) levels (all p < 0.05). Analysis of IR indicators showed that LF patients had significantly higher levels of TyG, TyG-WHtR, TyG-BMI, TyG-WC, TyG-GGT, METS-IR, and HOMA-IR (all p < 0.05). After adjusting for covariates, TyG-WHtR remained an independent risk factor (OR=2.69; 95% CI: 2.08-3.47), indicating a strong correlation with LF. The developed nomogram, incorporating AST, TyG, TyG-BMI, and diabetes, showed an AUC of 0.809 (95% CI: 0.771-0.847), indicating good predictive performance for LF in NAFLD patients.ConclusionsThis study confirms that a significant association between various IR and LF in NAFLD patients, and the developed nomogram provides a practical tool for early risk assessment. These findings underscore the clinical value of incorporating IR indices into routine practice to identify high-risk patients, enabling timely interventions to prevent fibrosis progression and improve outcomes. |
| format | Article |
| id | doaj-art-caacba0816a84bd39f19b07aae33b61d |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-caacba0816a84bd39f19b07aae33b61d2025-01-31T05:10:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011610.3389/fendo.2025.15140931514093Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020Bo Yang0Mingsu Gong1Xiaojie Zhu2Yang Luo3Ruiqiu Li4Hai Meng5Yuhan Wang6Department of Gastroenterology and Hepatology, Guizhou Aerospace Hospital, Zunyi, ChinaDepartment of Gastroenterology and Hepatology, Guizhou Aerospace Hospital, Zunyi, ChinaDepartment of Gastroenterology and Hepatology, Binhai County People’s Hospital, Yancheng, ChinaDepartment of Gastroenterology and Hepatology, Guizhou Aerospace Hospital, Zunyi, ChinaDepartment of Gastroenterology and Hepatology, Guizhou Aerospace Hospital, Zunyi, ChinaDepartment of Gastroenterology and Hepatology, Binhai County People’s Hospital, Yancheng, ChinaDepartment of Gastroenterology and Hepatology, Binhai County People’s Hospital, Yancheng, ChinaIntroductionNon-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, with liver fibrosis (LF) being a crucial pathological feature in the progression of NAFLD. Insulin resistance (IR) is believed to play an important role in the pathogenesis of NAFLD and the development of LF. This study aims to explore the relationship between various IR indicators and LF in patients with NAFLD.MethodsThis study utilized data from the National Health and Nutrition Examination Survey 2017-2020 cycles. Liver steatosis and fibrosis were assessed using liver ultrasound transient elastography. To assess the association between multiple IR indicators and LF, the study methodology included univariate and multivariate logistic regression, as well as restricted cubic spline (RCS) analysis. Subsequently, we used multivariate logistic regression to develop and validate a predictive model for LF, and evaluated the model’s performance using the area under the curve (AUC) and calibration curve.ResultsA total of 904 patients were included in the final analysis. Among these NAFLD patients, 153 (16.92%) had LF. Compared to non-LF patients, LF patients had significantly higher body mass index (BMI), waist circumference (WC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), HbA1c, and fasting blood glucose (FBG) levels (all p < 0.05). Analysis of IR indicators showed that LF patients had significantly higher levels of TyG, TyG-WHtR, TyG-BMI, TyG-WC, TyG-GGT, METS-IR, and HOMA-IR (all p < 0.05). After adjusting for covariates, TyG-WHtR remained an independent risk factor (OR=2.69; 95% CI: 2.08-3.47), indicating a strong correlation with LF. The developed nomogram, incorporating AST, TyG, TyG-BMI, and diabetes, showed an AUC of 0.809 (95% CI: 0.771-0.847), indicating good predictive performance for LF in NAFLD patients.ConclusionsThis study confirms that a significant association between various IR and LF in NAFLD patients, and the developed nomogram provides a practical tool for early risk assessment. These findings underscore the clinical value of incorporating IR indices into routine practice to identify high-risk patients, enabling timely interventions to prevent fibrosis progression and improve outcomes.https://www.frontiersin.org/articles/10.3389/fendo.2025.1514093/fullnon-alcoholic fatty liver diseaseliver fibrosisinsulin resistancelogistic regressionTyG-WHtR |
| spellingShingle | Bo Yang Mingsu Gong Xiaojie Zhu Yang Luo Ruiqiu Li Hai Meng Yuhan Wang Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 Frontiers in Endocrinology non-alcoholic fatty liver disease liver fibrosis insulin resistance logistic regression TyG-WHtR |
| title | Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 |
| title_full | Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 |
| title_fullStr | Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 |
| title_full_unstemmed | Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 |
| title_short | Correlation between liver fibrosis in non-alcoholic fatty liver disease and insulin resistance indicators: a cross-sectional study from NHANES 2017–2020 |
| title_sort | correlation between liver fibrosis in non alcoholic fatty liver disease and insulin resistance indicators a cross sectional study from nhanes 2017 2020 |
| topic | non-alcoholic fatty liver disease liver fibrosis insulin resistance logistic regression TyG-WHtR |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1514093/full |
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