Comparative characteristics of the triglyceride-glucose index and the homeostatic index of insulin resistance in various forms of non-alcoholic fatty liver disease

Introduction.  Insulin  resistance (IR) is a key mechanism  in the  development of non-alcoholic fatty  liver disease  (NAFLD). To identify IR, various indices have been  proposed, but their comparative diagnostic  significance  is not sufficiently covered.

Aim. To conduct a comparative analysis of the diagnostic  role of the triglyceride-glucose index (TyG Index or TGI) and HOMA-IR in different  forms of NAFLD – hepatic  steatosis (SP) and steatohepatitis (SH).

Materials and methods.  194 patients with NAFLD were examined: 56 (28.9%) LS and 138 (71.1%)  SH. TGI, HOMA-IR, fragments of cytokeratin-18 (FCK-18), tumor  necrosis  factor alpha  (TNF-α), fibrosis index – NAFLD fibrosis index (NFS), traditional liver tests  were determined.

Results. TGI was increased in 43 (76.8%) patients with LS and  its average  level  was 9.0 ± 0.4, it positively correlated with obesity,  dyslipidemia,   HOMA-IR,  hepatocellular  damage   and   negatively   with   albumin   levels.  HOMA-IR was   elevated in 33 (58.9%) patients with SH, its level was 3.58 ± 1.7, it positively correlated with BMI, TGI and ESR. In SH, the level of TGI was increased in 125 (90.6%) patients, its level was 9.2 ± 0.6, it positively correlated with waist circumference,  dyslipidemia, ALT, and negatively  with albumin levels. HOMA-IR in SH increased in 111 (80.4%) patients, its level was 4.78 ± 1.8, it positively correlated with indicators  of abdominal  obesity, ALT, ESR, FCK-18 and NFS.

Conclusion. An increase  in TGI was detected in NAFLD more  often  – in 86.6% of patients than  an increase  in HOMA-IR – in 74.2% (p > 0.05). Both indices increased more often in SH than  in LS. TGI indirectly reflected the degree  of protein  metabolism disturbance and the  level of hepatic  cell necrosis, while HOMA-IR reflected the  level of hepatocyte apoptosis,  inflammation, and liver fibrosis in SH.

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