Duan Shaojie, Chen Mengdie, Chen Jie, Shao Yaojian, Jin Xiaolong, Wang Chaohui, Feng Ping, Teng Xiaosheng, Yu Zhenjun
Departments of Gastroenterology.
Geriatrics.
Eur J Gastroenterol Hepatol. 2025 Oct 1;37(10):1155-1165. doi: 10.1097/MEG.0000000000002998. Epub 2025 May 6.
Insulin resistance plays a pivotal role in the progression of type 2 diabetes mellitus (T2DM). An in-depth investigation into the role of insulin resistance scores in evaluating T2DM combined with metabolic-associated fatty liver disease (MAFLD) and liver fibrosis holds significant importance for clinical decisions and personalized treatment.
The study screened patients with diabetes from Taizhou Central Hospital from June 2020 to May 2024. In conjunction with the National Health and Nutrition Examination Survey (NHANES) database, various statistical methods such as logistic regression analysis, restricted cubic spline, and receiver operating characteristic curves were employed to complete data analysis.
This study encompassed 3776 patients with T2DM, including 1074 diagnosed with MAFLD. Insulin resistance scores in the MAFLD group were significantly elevated. Compared with nonfibrotic patients, those with T2DM and liver fibrosis exhibited notably higher Chinese visceral adiposity index (CVAI) scores and notably lower triglyceride-glucose index and visceral adiposity index scores; the incidence of hypertension, coronary heart disease, stroke, and peripheral arterial disease were significantly elevated. Among other insulin resistance scores, the CVAI score demonstrated the highest value for correlating with the MAFLD and liver fibrosis in patients with T2DM. The NHANES database, encompassing data from 6763 individuals, validated the aforementioned findings, further affirming that the CVAI score exhibited optimal consistency with the risk of T2DM with MAFLD and liver fibrosis.
The insulin resistance scores were significantly elevated in T2DM combined with MAFLD. The CVAI score demonstrated the best predictive effect on MAFLD and liver fibrosis.
胰岛素抵抗在2型糖尿病（T2DM）的进展中起关键作用。深入研究胰岛素抵抗评分在评估T2DM合并代谢相关脂肪性肝病（MAFLD）和肝纤维化中的作用，对临床决策和个性化治疗具有重要意义。
该研究筛选了2020年6月至2024年5月期间台州中心医院的糖尿病患者。结合美国国家健康与营养检查调查（NHANES）数据库，采用逻辑回归分析、受限立方样条和受试者工作特征曲线等多种统计方法完成数据分析。
本研究纳入了3776例T2DM患者，其中1074例被诊断为MAFLD。MAFLD组的胰岛素抵抗评分显著升高。与无纤维化患者相比，T2DM合并肝纤维化患者的中国内脏脂肪指数（CVAI）得分显著更高，甘油三酯-葡萄糖指数和内脏脂肪指数得分显著更低；高血压、冠心病、中风和外周动脉疾病的发生率显著升高。在其他胰岛素抵抗评分中，CVAI评分在T2DM患者中与MAFLD和肝纤维化的相关性最高。包含6763名个体数据的NHANES数据库验证了上述发现，进一步证实CVAI评分与T2DM合并MAFLD和肝纤维化的风险具有最佳一致性。
T2DM合并MAFLD时胰岛素抵抗评分显著升高。CVAI评分对MAFLD和肝纤维化的预测效果最佳。
