Comparative characteristics of the diagnostic significance of non-insulin indices of insulin resistance in assessing inflammation in metabolically associated steatotic liver disease

The aim of the study was to determine the diagnostic value of various calculated non-insulin indices of insulin resistance (IR) as surrogate markers of inflammation in metabolically associated steatotic liver disease (MASLD) in patients without type 2 diabetes mellitus. Materials and methods. Fifty-one patients with MASLD were examined: 29 (56.9%) men and 22 (43.1%) women and 40 healthy donors. The IR indices were estimated: triglyceride-glucose index (TGI) = ln[(triglycerides mg/dl x fasting glucose mg/dl)/2]; TGI x body mass index (TGI х BMI); lipid accumulation product (LAP) for men = [(waist circumference (WC) cm - 65) x TG (mmol/L)] and LAP for women = [(WC - 58) x TG (mmol/L)]; visceral adiposity index (VAI) for men = [WC (cm)/39.68 + (1.88 × BMI)] × (TG (mmol/l)/1.03) × (1.31/HDL (mmol/l) and VAI for women = [WC (cm)/36.58 + 1.89 × (BMI)] × (TG (mmol/l)/0.81) × (1.52/HDL (mmol/l) and the ratio of triglycerides to high-density lipoproteins (TG/HDL). The ELISA method was used to determine the proinflammatory cytokines TNF-α (“Cloud-clone corp”, USA), IL-1β, IL-6 (“Vector-Best”, Russia) and IL-8 (“Cloud-clone corp”, USA). Results. All IR indices in patients with MASLD significantly exceeded those in healthy donors: LAP increased to the maximum - 4.5 times (p = 0.003), VAI - 2.6 times (p = 0.04), TGI x BMI - 2.3 times (p = 0.03), TG/HDL - 2.1 times (p < 0.001) and TGI - 1.1 times (p < 0.001). When analyzing the correlation links of IR with inflammation indicators, a direct correlation was found between TG/HDL and the levels of IL-8 - r = 0.63 (p = 0.02), IL-6 - r = 0.52 (p = 0.04) and AST - r = 0.56 (p = 0.001). TGI correlated with the level of IL-8 - r = 0.65 (p = 0.02). Conclusion. TG/HDL, an easily accessible and inexpensive index of insulin resistance, has demonstrated diagnostic value as a surrogate marker of inflammation in MASLD.

metabolically associated steatotic liver disease, non-insulin indices of insulin resistance, inflammation, cytokines

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