Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Department of Medicine, Graduate School of Hanyang University, Seoul, Korea.
Clin Mol Hepatol. 2022 Oct;28(4):814-826. doi: 10.3350/cmh.2022.0099. Epub 2022 Jun 9.
BACKGROUND/AIMS: The early detection and prevention of non-alcoholic fatty liver disease (NAFLD) has been emphasized considering the burden of this disease. Both hepatic and peripheral insulin resistances are strongly associated with NAFLD. We aimed to compare the predictive powers of a hepatic insulin resistance index, the homeostatic model assessment for insulin resistance (HOMA-IR), and a novel peripheral insulin resistance index, the metabolic score for insulin resistance (METS-IR), for the prediction of prevalent and incident NAFLD.
Data from 8,360 adults aged 40-69 years at baseline and 5,438 adults without NAFLD who were followed-up at least once after the baseline survey in the Korean Genome and Epidemiology Study were analyzed. The survey was performed biennially, up to the eighth follow-up.
The predictive powers of the METS-IR and HOMA-IR for prevalent NAFLD were not significantly different (area under the receiver operating characteristic [ROC] curve [95% confidence interval]: METS-IR, 0.824 [0.814-0.834]; HOMAIR, 0.831 [0.821-0.842]; P=0.276). The area under the time-dependent ROC curve (Heagerty's integrated area under the curve) of the METS-IR for incident NAFLD was 0.683 (0.671-0.695), significantly higher than that of the HOMA-IR (0.551 [0.539-0.563], P<0.001).
The METS-IR is superior to the HOMA-IR for the prediction of incident NAFLD and is not inferior to the HOMA-IR for the prediction of prevalent NAFLD. This suggests that the METS-IR can be a more useful insulin resistance index than the HOMA-IR for the early detection and prevention of NAFLD in Korean population.
背景/目的：鉴于非酒精性脂肪性肝病（NAFLD）的负担，强调了对其的早期检测和预防。肝和外周胰岛素抵抗与 NAFLD 密切相关。我们旨在比较肝胰岛素抵抗指数、稳态模型评估的胰岛素抵抗（HOMA-IR）和新的外周胰岛素抵抗指数、代谢评分的胰岛素抵抗（METS-IR）对预测现患和新发 NAFLD 的预测能力。
对基线时年龄为 40-69 岁的 8360 名成年人和基线后至少随访一次且无 NAFLD 的 5438 名成年人的数据进行了分析，这些成年人参加了韩国基因组和流行病学研究。该调查每两年进行一次，最多进行八次随访。
METS-IR 和 HOMA-IR 对现患 NAFLD 的预测能力无显著差异（接受者操作特征曲线下面积[95%置信区间]：METS-IR，0.824[0.814-0.834]；HOMA-IR，0.831[0.821-0.842]；P=0.276）。METS-IR 对新发 NAFLD 的时间依赖性 ROC 曲线下面积（Heagerty 综合曲线下面积）为 0.683（0.671-0.695），显著高于 HOMA-IR（0.551[0.539-0.563]，P<0.001）。
METS-IR 对预测新发 NAFLD 优于 HOMA-IR，对预测现患 NAFLD 与 HOMA-IR 无差异。这表明，在韩国人群中，METS-IR 可能比 HOMA-IR 更能作为一种有用的胰岛素抵抗指数，用于 NAFLD 的早期检测和预防。
