Diabetes Metabolic Syndrome and Obesity
Diagnostic Performance of Six Insulin Resistance Indices for MAFLD Across BMI Categories in Type 2 Diabetes
By Jie Tao, Yun Zhong, Hong Li and 2 others.
Abstract
Objective
To evaluate the diagnostic utility of six insulin resistance surrogate indices for metabolic dysfunction-associated fatty liver disease (MAFLD) across different body mass index (BMI) categories in patients with type 2 diabetes (T2DM).
Methods
This single-center, cross-sectional study utilized a consecutive sampling method and was conducted at the Department of Endocrinology and Geriatrics, Huaian First People’s Hospital (January 2018 to December 2022). Inclusion criteria were age ≥ 18 years and confirmed T2DM. A total of 2079 hospitalized adult patients meeting these criteria were initially screened. After applying exclusion criteria (including other diabetes types, secondary liver diseases, excessive alcohol consumption, low BMI, and incomplete data), 1205 patients with T2DM were enrolled and stratified by body mass index (BMI) into normal weight (n=429) and overweight/obese groups (n=776). MAFLD was diagnosed based on abdominal ultrasound, yielding 636 cases of MAFLD and 569 non-MAFLD controls. Six insulin resistance surrogate indices—homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C), and Chinese visceral adiposity index (CVAI)—were assessed for their diagnostic performance using receiver operating characteristic (ROC) analysis, DeLong’s test, and decision curve analysis (DCA).
