Evidence map›Paper›PMID 40606918›Full record

ArticleWorld journal of hepatology2025

Association between insulin and liver function tests, liver disease and cirrhosis in population-based cohorts with long term follow-up.

Andreas Schult, Kirsten Mehlig, Kurt Svärdsudd, Sven Wallerstedt, Cecilia Björkelund, Per-Olof Hansson, Henrik Zetterberg, Jerzy Kaczynski

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In one paragraph

Article in World journal of hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Frontiers in immunology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Andreas SchultDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41390, Västra Götaland, Sweden.
Kirsten MehligDepartment of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg 40530, Västra Götaland, Sweden.
Kurt SvärdsuddDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, University Uppsala, Uppsala 75310, Sweden.
Sven WallerstedtDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41390, Västra Götaland, Sweden.
Cecilia BjörkelundPrimary Health Care/Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg 41390, Västra Götaland, Sweden.
Per-Olof HanssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41390, Västra Götaland, Sweden.
Henrik ZetterbergDepartment of Psychiatry and Neurochemistry, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden, Gothenburg 41390, Västra Götaland, Sweden.
Jerzy KaczynskiDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 41390, Västra Götaland, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels. It is associated with fatty liver disease and elevated liver function tests (LFT) in cross-sectional studies, but data from cohort studies are scarce.

aimTo investigate the association between insulin and pathological LFT, liver disease, and cirrhosis in a population-based retrospective cohort study.

methodsAnthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used. LFT were obtained at two time points 8 years to 24 years after baseline. Liver disease diagnoses were obtained from nationwide registries. The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.

resultsTotal follow-up was 54054 person-years for women and 27556 person-years for men. Insulin levels were positively correlated with elevated LFT during follow-up, whereas physical activity and coffee consumption were negatively correlated. Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease, adjusted hazard ratio (aHR) of 4.3 (95%CI: 1.6-14.6) and cirrhosis (aHR = 4.8, 95%CI: 1.6-14.6).

conclusionThis population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease. The results support the concept of metabolic dysfunction associated liver disease.

Indexed as

AlcoholInsulinLiver cirrhosisLiver function testsMetabolic dysfunction associated steatotic liver disease

Identifiers

PMID40606918
PMCPMC12210178

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.