Novel Surrogate Markers of Insulin Resistance in Patients with Metabolic Dysfunction-Associated Steatosis Liver Disease: Associations with Dietary and Lifestyle Inflammatory Scores in the Large Cross-sectional Study.
Yusuf Yilmaz, Behrad Saeedian, Nastaran Babajani, Sara Ashtari, Fereshteh Ghorat, Ehsaneh Taheri
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引用次数: 0
Abstract
Background & aims: Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a major global health challenge, with insulin resistance (IR) and inflammation being key pathophysiological drivers. Here, this study aimed to evaluate the associations between MASLD and novel IR markers, and to examine the interrelationships between dietary (DIS) and lifestyle (LIS) inflammatory scores and IR indices.
Methods: This cross-sectional study was conducted among participants in the baseline phase of the Sabzevar Persian Cohort Study (SPCS). We studied 970 patients with MASLD and 961 age- and sex-matched controls. Eight distinct IR markers were assessed: triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c), lipid accumulation product (LAP), visceral adiposity index (VAI), and metabolic score for insulin resistance (METS-IR). DIS was calculated from 19 dietary components, LIS from three lifestyle parameters, and a combined dietary and lifestyle inflammation score (DLIS) from both measures.
Results: Patients with MASLD exhibited higher adiposity measures and comorbidity rates than controls. TyG-BMI demonstrated the strongest association with MASLD (area under the curve [AUC]: 0.994), followed by TyG-WC (AUC: 0.993) and METS-IR (AUC: 0.989). TyG-BMI demonstrated the highest specificity (96.74%), indicating its strong ability to correctly identify individuals without the disease (true negatives), thereby minimizing false positives. In contrast, TyG-WC showed the highest sensitivity (97.31%), reflecting its excellent capacity to correctly detect individuals with the disease (true positives), thus reducing the likelihood of false negatives.LIS correlated most strongly with TyG-BMI (r = 0.811, p < 0.001), whereas DLIS correlated best with METS-IR (r = 0.346, p < 0.001). Canonical correlation analysis revealed significant relationships between inflammatory scores and IR indices (r = 0.835, p < 0.001).
Conclusions: Among novel IR markers, TyG-BMI represented the most robust surrogate marker associated with the risk of having MASLD. The strong correlation between LIS and TyG-BMI suggested the potential significant association of lifestyle-related inflammation and IR in MASLD pathophysiology that needs to be investigated in future interventional studies.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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