Insulin Resistance and Glycaemic Markers in NAFLD Patients

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder worldwide, mainly associated with obesity and insulin resistance. Aims: This study aimed to evaluate the association between NAFLD and   insulin resistance.     Methods: A comparative cross-sectional study was conducted at Zliten Medical Centre (ZMC) from February to August 2025. It included 85 participants (55 with NAFLD and 30 healthy controls). Age, gender, Body mass index (BMI), fasting blood glucose (FBG), HbA1c (glycated heamoglobin), and serum insulin were measured. Insulin resistance was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index. Results: Patients with NAFLD had significantly higher BMI, FBG, HbA1c, serum insulin, and HOMA-IR compared to controls. Mann–Whitney U tests showed significant differences in HOMA-IR, HbA1c.  Receiver Operator curve (ROC) analysis indicated excellent diagnostic accuracy for insulin and HOMA-IR (AUC) (Area under curve) ` ≈ 0.88). Regression analysis revealed that insulin and HOMA-IR were positively associated with NAFLD risk. The linear regression analysis revealed that among metabolic parameters in NAFLD group, HbA1c had a significant association with HOMA-IR, while BMI showed weak or non-significant relationships; the logistic regression model showed an excellent accuracy (AUC = 0.998), indicating strong prediction ability for NAFLD compared to previous studies. Conclusion: Insulin resistance plays a pivotal role in fatty liver development ,that could be concluded from elevated insulin, HOMA-IR, and impaired glycaemic control. higher BMI, further highlighting the underlying metabolic abnormalities. Insulin and HOMA-IR may be used as clinical markers for identifying high-risk individuals. Early diagnosis and lifestyle modification targeting insulin resistance are recommended.