ArticleBMC gastroenterology2025
Associations between non-insulin-based insulin resistance surrogate markers and liver-related outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide cohort study in South Korea.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Interpreting the triglyceride-glucose index and its derived indices in metabolic dysfunction-associated steatotic liver disease: clinical utility and evidence gaps.Frontiers in medicine · 2026Review
- A structured list of laboratory tests for screening the possible causes of small fiber neuropathy in clinical practice.Frontiers in neurology · 2025Review
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6 authors.
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Abstract
backgroundInsulin resistance (IR) is a crucial mechanism in the pathogenesis and clinical progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to examine the relationship between non-insulin-based IR surrogate markers and the incidence of liver-related outcomes in individuals with MASLD in a nationwide Korean cohort.
methodsA total of 66,334 individuals with MASLD who underwent a health examination between 1 January 2009 and 31 December 2010 were included in the study and followed until 31 December 2019, with a median follow-up period of 9.4 years. Hepatic steatosis was defined as a fatty liver index ≥ 30. The triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol (TG/HDL) ratio, and metabolic score of IR (METS-IR) were employed as non-insulin-based IR surrogate markers. The MASLD groups were divided into four groups based on the non-insulin-based IR surrogate markers quartiles. The primary outcome was liver-related outcomes, as a composite of hepatocellular carcinoma and decompensated liver cirrhosis.
resultsThe MASLD group was 64.4% male (average age, 59.0 years). Using the lowest quartile (Q1) of the three non-insulin-based IR surrogate markers as a reference, a decrease in the adjusted hazard ratio for liver-related outcomes was observed from Q2 to Q4: (TyG: Q2 0.90 [95% confidence interval [CI]: 0.79-1.02], Q3 0.80 [95% CI: 0.70-0.91], Q4 0.80 [95% CI: 0.69-0.92]; TG/HDL: Q2 0.85 [95% CI: 0.75-0.97], Q3 0.81 [95% CI: 0.71-0.92], Q4 0.81 [95% CI: 0.71-0.93]; METS-IR: Q2 0.83 [95% CI: 0.73-0.95], Q3 0.80 [95% CI: 0.70-0.91], Q4 0.80 [95% CI: 0.70-0.92]).
conclusionsA lower non-insulin-based IR surrogate marker in the MASLD group may be associated with an increased risk of liver-related outcomes. In the course of monitoring MASLD, metabolic alterations must be meticulously observed.
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