Correlation Between Insulin Resistance (HOMA-IR) with Stages of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) assessed by Fibroscan
DOI:
https://doi.org/10.64149/J.Carcinog.24.2s.1267-1275Keywords:
MASLD, Insulin Resistance, HOMA-IR, Liver Fibrosis, Steatosis, FibroscanAbstract
Background: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is a growing global health concern, often progressing to advanced liver fibrosis and cirrhosis. Insulin resistance (IR) is a key pathophysiological driver of MASLD. Non-invasive methods like Fibroscan provide valuable insights into liver steatosis and fibrosis. However, the precise correlation between HOMA-IR, a widely used index for insulin resistance, and MASLD severity remains to be fully elucidated.
Aim: To investigate the correlation between insulin resistance, as measured by Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), and the stages of MASLD assessed by Fibroscan in Bangladeshi population.
Methods: This cross-sectional study was conducted at the Department of Hepatology, Shaheed Tajuddin Ahmad Medical College, Gazipur. A total of 70 patients with clinically suspected or confirmed MASLD were included. Demographic, clinical, and biochemical data were collected. Liver fibrosis (F0–F4) and steatosis (S0–S3) were assessed using Fibroscan. HOMA-IR was calculated from fasting insulin and fasting glucose levels. Statistical analysis was done using SPSS version 26.0.
Results: The mean age of participants was 43.5 ± 12.1 years, and 44.3% were male. The mean HOMA-IR = 2.89 ± 1.54. A significant positive correlation was found between HOMA-IR and both liver fibrosis stage (r = 0.65, p < 0.001) and steatosis grade (r = 0.58, p < 0.001). HOMA-IR was significantly higher in patients with advanced fibrosis (F3–F4) and severe steatosis (S3). Multivariable logistic regression analysis, adjusted for age, sex, and BMI, demonstrated that HOMA-IR independently predicted both advanced fibrosis (adjusted OR: 1.8; 95% CI: 1.3–2.5; p = 0.008) and severe steatosis (adjusted OR: 1.5; 95% CI: 1.1–2.0; p = 0.030).
Conclusion: There is a strong positive correlation between insulin resistance (HOMA-IR) and the severity of MASLD as assessed by Fibroscan. HOMA-IR is an independent predictor of advanced fibrosis and steatosis, and may serve as a practical non-invasive biomarker for risk stratification in MASLD
