The Correlation between Insulin Resistance and Fatty Liver Disease in Qena University Hospital: Cross-Sectional Study

Mahmoud, Hasan Sedeek ٍ; Abd El-Monem, Shimaa Arafat; Agaiby, Abanoub Safwat Zakhary; Hassan, Mohammed H.

doi:10.21608/svuijm.2025.398267.2208

The Correlation between Insulin Resistance and Fatty Liver Disease in Qena University Hospital: Cross-Sectional Study

Document Type : Original research articles

Authors

¹ Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

² Medical Biochemistry Department, Faculty of Medicine, South Valley University, Qena, Egypt.

10.21608/svuijm.2025.398267.2208

Abstract

Background: Insulin resistance, driven by inactivity and overnutrition, disrupts glucose and lipid metabolism and contributes to metabolic syndrome, obesity, type 2 diabetes mellitus (T2DM), atherosclerosis, and nonalcoholic fatty liver disease (NAFLD). The liver plays a pivotal role, and NAFLD is the most common chronic liver disease, strongly associated with metabolic dysfunction.
Objectives: To determine the features of NAFLD in insulin-resistant, non-diabetic, non-alcoholic individuals and identify associated risk factors.
Patients and methods: This cross-sectional case-control study included 100 non-alcoholic, non-diabetic patients with insulin resistance (55 with NAFLD and 45 with non-NAFLD) and 50 controls, excluding any with liver-affecting conditions. All underwent a battery of lab tests, including CBC, liver and renal function, lipid profile, glucose, HbA1c, insulin, and adiponectin. Liver stiffness and steatosis were assessed using abdominal ultrasound and FibroScan. LSM values staged fibrosis, and CAP ≥ 238 dB/m is used to diagnose steatosis.
Results: Mean age was 49.71±16.71 years; 52.67% were male. NAFLD cases had significantly higher BMI (37.46±2 kg/m²), WC (101.4±6.15 cm), HbA1c (6.04±0.19%), fasting glucose (111.38±7.37 mg/dL), HOMA-IR (9.92±3.86), ALT, AST, bilirubin, and PT/INR (P < 0.0001) compared to those without NAFLD and the control groups. Serum adiponectin was lower (26.87±10.35 ng/mL, P = 0.006). LSM (9.68±2.66 kPa) and CAP (279.07±18.06 dB/m) were significantly elevated in NAFLD. The ROC curve revealed that HOMA-IR showed 83.6% sensitivity, 77.9% specificity, and 80% accuracy. Adiponectin showed 74.5% sensitivity, 50.5% specificity, and 59.33% accuracy. Elevated HbA1c and dyslipidemia are independent risk factors for NAFLD.
Conclusion: NAFLD in insulin-resistant individuals is linked to significant hepatic and metabolic alterations. CAP, LSM, and HOMA-IR are valuable diagnostic tools for NAFLD.

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