Comparative characteristics of the triglyceride-glucose index and the homeostatic index of insulin resistance in various forms of non-alcoholic fatty liver disease

Abstract

Introduction . Insulin resistance (IR) is a key mechanism in the development of non-alcoholic fatty liver disease (NAFLD). To identify IR, various indices have been proposed, but their comparative diagnostic significance is not sufficiently covered. Aim . To conduct a comparative analysis of the diagnostic role of the triglyceride-glucose index (TyG Index or TGI) and HOMA-IR in different forms of NAFLD – hepatic steatosis (SP) and steatohepatitis (SH). Materials and methods . 194 patients with NAFLD were examined: 56 (28.9%) LS and 138 (71.1%) SH. TGI, HOMA-IR, fragments of cytokeratin-18 (FCK-18), tumor necrosis factor alpha (TNF-α), fibrosis index – NAFLD fibrosis index (NFS), traditional liver tests were determined. Results . TGI was increased in 43 (76.8%) patients with LS and its average level was 9.0 ± 0.4, it positively correlated with obesity, dyslipidemia, HOMA-IR, hepatocellular damage and negatively with albumin levels. HOMA-IR was elevated in 33 (58.9%) patients with SH, its level was 3.58 ± 1.7, it positively correlated with BMI, TGI and ESR. In SH, the level of TGI was increased in 125 (90.6%) patients, its level was 9.2 ± 0.6, it positively correlated with waist circumference, dyslipidemia, ALT, and negatively with albumin levels. HOMA-IR in SH increased in 111 (80.4%) patients, its level was 4.78 ± 1.8, it positively correlated with indicators of abdominal obesity, ALT, ESR, FCK-18 and NFS. Conclusion . An increase in TGI was detected in NAFLD more often – in 86.6% of patients than an increase in HOMA-IR – in 74.2% (p > 0.05). Both indices increased more often in SH than in LS. TGI indirectly reflected the degree of protein metabolism disturbance and the level of hepatic cell necrosis, while HOMA-IR reflected the level of hepatocyte apoptosis, inflammation, and liver fibrosis in SH.