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KMID : 1039620230130040233
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Korean Journal of Family Practice
2023 Volume.13 No. 4 p.233 ~ p.239
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Homeostatic Model Assessment of Insulin Resistance as a Potential Screening Test for Non-Alcoholic Fatty Liver Disease in Korean Adults without Diabetes
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Lee Hye-Jung
Lee Jae-Ho
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Abstract
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Background: Non-alcoholic fatty liver disease (NAFLD) prevalence rapidly increases worldwide and may lead to end-stage liver disease such as cirrhosis or hepatocellular carcinoma. This study aimed to examine the relationship between NAFLD and insulin resistance, evaluate the accuracy of homeostatic model assessment of insulin resistance (HOMA-IR) for NAFLD in Korean adults without diabetes as a screening tool, and estimate the optimal cut-off value for distinguishing NAFLD from non-NAFLD.
Methods: This cross-sectional study included 12,924 Korean adults aged ≥19 years who participated in the Korean National Health and Nutrition Examination Survey, 2019?2021. Subjects were categorized into two groups based on the hepatic steatosis index (≥30 or <30) as a simple screening tool for NAFLD. We used HOMA-IR as a method to measure insulin resistance. The receiver operating characteristic analysis determined the optimal cut-off value for identifying NAFLD. The association between NAFLD and HOMA-IR was examined using logistic regression analysis.
Results: The area under the curve of HOMA-IR to identify NAFLD was 76.3%. The optimal threshold of HOMA-IR for distinguishing NAFLD from non- NAFLD was 1.665. HOMA-IR cut-off was associated with NAFLD (odds ratio, 1.77; 95% confidence interval, 1.53?2.04; P<0.001), independent from general characteristics, triglyceride levels, and body mass index.
Conclusion: HOMA-IR is independently associated with NAFLD in adults without diabetes and could be used as a screening tool in clinical practice.
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KEYWORD
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Insulin Resistance, Korean Adults, Non-Alcoholic Fatty Liver Disease, Diabetes Mellitus
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