Insulin Resistance Markers to Detect Nonalcoholic Fatty Liver Disease in a Male Hispanic Population

Abstract

Background. Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease and is closely associated with cardiometabolic disorders, being insulin resistance (IR) the common pathogenic mechanism. The triglycerides/glucose (TyG) index and triglycerides/HDL-c (TG/HDL) ratio are markers correlated with IR. We compared the capacity of these two indexes, alongside IR, to detect NAFLD. Methods. In a cross-sectional cohort study, we examined 263 active military personnel from the Colombian Air Force, aged between 29 and 54 years. Anthropometric measurements and biochemical determinations (glycemia, lipid profile, and insulin) were obtained, and ultrasound studies were performed to evaluate the presence of NAFLD. HOMA-IR index was calculated as (fasting insulin (µIU/mL) × fasting glucose (mmol/L)/22.5), the TyG index as Ln (triglycerides (mg/dL) × fasting glucose (mg/dL)/2), and the TG/HDL ratio as (triglycerides (mg/dL)/HDL-c (mg/dL)). Results. NAFLD ultrasound criteria were met in 70 individuals (26.6%). Subjects with NAFLD had significantly higher values of HOMA-IR (2.55 ± 1.36 vs. 1.51 ± 0.91), TyG (9.17 ± 0.53 vs. 8.7 ± 0.51), and TG/HDL (6.6 ± 4.54 vs. 3.52 ± 2.32) compared to those without NAFLD p < 0.001 . A TyG cutoff point of 8.92 showed an AUC of 0.731, while cutoff points of 3.83 for TG/HDL and 1.68 for HOMA-IR showed an AUC of 0.766 and 0.781, respectively. Conclusion. Our study shows that novel and lower-cost markers of IR are useful for detecting NALFD, with a performance comparable to the HOMA-IR index. These markers should be used as the first step when screening patients for NAFLD.

Triglyceride to high-density lipoprotein cholesterol ratio as a marker of non-alcoholic fatty liver disease in type 2 diabetes

“…In general, our results are consistent with previous studies regarding the association between the TG/HDL-C ratio and NAFLD. Our present study indicated that subjects with hepatic steatosis had significantly higher TG/HDL-C ratio values than those without hepatic steatosis, comparable to the results of prior studies [10], [16]- [19]. The TG/HDL-C ratio is independently correlated with NAFLD, according to two large cross-sectional studies [16], [17].…”

“…Another cohort study also reported an independent association between the TG/HDL-C ratio and NAFLD in non-obese subjects [18]. The TG/HDL-C ratio is also effective in detecting NAFLD, as reported by Fan et al [17], Chen et al [18], and and Pérez-Mayorga et al [19], with cut-off values ranging from 0.64 to 3.83, probably related to ethnic differences. However, most of those studies involved apparently healthy individuals who were not diabetic, except for the study by Li et al [10], which involved newly diagnosed T2DM patients.…”