The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults

다국어 초록 (Multilingual Abstract)

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.
Methods: 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.
Results: 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).
Conclusions: 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.

참고문헌 (Reference)

1 장민혜 ; 원장원 ; 최현림 ; 김선영 ; 박우철 ; 김동후 ; 정수진 ; 김병성, "성인에서 신체활동이 골절 발생에 미치는 영향: 한국 지역사회 코호트 자료에 기반" 대한스포츠의학회 35 (35): 97-102, 2017

2 Ahn Y, "Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study" 61 : 1435-1441, 2007

3 Isokuortti E, "Use of HOMA-IR to diagnose non-alcoholic fatty liver disease : a population-based and interlaboratory study" 60 : 1873-1882, 2017

4 Heagerty PJ, "Time-dependent ROC curves for censored survival data and a diagnostic marker" 56 : 337-344, 2000

5 Kamarudin AN, "Time-dependent ROC curve analysis in medical research : current methods and applications" 17 : 53-, 2017

6 Chobanian AV, "The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure : the JNC 7 report" 289 : 2560-2572, 2003

7 Im HJ, "Systematic review on the prevalence of nonalcoholic fatty liver disease in South Korea" 45 : 101526-, 2021

8 Heagerty PJ, "Survival model predictive accuracy and ROC curves" 61 : 92-105, 2005

9 Utzschneider KM, "Review : the role of insulin resistance in nonalcoholic fatty liver disease" 91 : 4753-4761, 2006

10 Santoleri D, "Resolving the paradox of hepatic insulin resistance" 7 : 447-456, 2019

11 Harrell FE Jr, "Regression models for prognostic prediction : advantages, problems, and suggested solutions" 69 : 1071-1077, 1985

12 Kotronen A, "Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors" 137 : 865-872, 2009

13 Birkenfeld AL, "Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes" 59 : 713-723, 2014

14 Gruben N, "Nonalcoholic fatty liver disease : a main driver of insulin resistance or a dangerous liaison?" 1842 : 2329-2343, 2014

15 Marchesini G, "NAFLD incidence and remission : only a matter of weight gain and weight loss?" 62 : 15-17, 2015

16 Abdul-Ghani MA, "Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test" 30 : 89-94, 2007

17 Jarvis H, "Metabolic risk factors and incident advanced liver disease in non-alcoholic fatty liver disease(NAFLD) : a systematic review and meta-analysis of population-based observational studies" 17 : e1003100-, 2020

18 Bello-Chavolla OY, "METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes" 178 : 533-544, 2018

19 강성희 ; 이혜원 ; Jeong-Ju Yoo ; 조유리 ; 김승업 ; Tae Hee Lee ; Byoung Kuk Jang ; Sang Gyune Kim ; Sang Bong Ahn ; Haeryoung Kim ; Dae Won Jun ; 최준일 ; Do Seon Song ; Won Kim ; Soung Won Jeong ; 김문영 ; 고홍 ; 정수진 ; Jin Woo Lee ; Yong Kyun Cho ; The Korean Association for the Study of the Liver (KASL), "KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease" 대한간학회 27 (27): 363-401, 2021

20 Salgado AL, "Insulin resistance index(HOMA-IR)in the differentiation of patients with non-alcoholic fatty liver disease and healthy individuals" 47 : 165-169, 2010

21 Youden WJ, "Index for rating diagnostic tests" 3 : 32-35, 1950

22 Hwang JH, "Increased intrahepatic triglyceride is associated with peripheral insulin resistance : in vivo MR imaging and spectroscopy studies" 293 : E1663-E1669, 2007

23 Matthews DR, "Homeostasis model assessment : insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man" 28 : 412-419, 1985

24 이윤정 ; 송수진 ; 송윤주, "High-Carbohydrate Diets and Food Patterns and Their Associations with Metabolic Disease in the Korean Population" 연세대학교의과대학 59 (59): 834-842, 2018

25 Sonia M. Najjar, "Hepatic Insulin Clearance: Mechanism and Physiology" American Physiological Society 34 (34): 198-215, 2019

26 DeFronzo RA, "Glucose clamp technique : a method for quantifying insulin secretion and resistance" 237 : E214-E223, 1979

27 Younossi Z, "Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis" 69 : 2672-2682, 2019

28 National Institute of Health, "Follow-up status according to each KoGES cohort (Kor)"

29 Expert Panel on Detection, "Executive summary of the third report of the national cholesterol education program(NCEP)Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)" 285 : 2486-2497, 2001

30 Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge" 18 : 499-502, 1972

31 Duseja A, "Epidemiology and risk factors of nonalcoholic fatty liver disease(NAFLD)" 7 (7): 755-764, 2013

32 European Association for the Study of the Liver (EASL), "EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease" 64 : 1388-1402, 2016

33 이상열 ; 권미광 ; 박병조 ; 천숙 ; 정인경 ; 오승준 ; 안규정 ; 정호연 ; 김성운 ; 김진우 ; 김영설 ; 우정택, "Differences in Insulin Sensitivity and Secretory Capacity Based on OGTT in Subjects with Impaired Glucose Regulation" 대한내과학회 22 (22): 270-274, 2007

34 Ainsworth BE, "Compendium of physical activities : an update of activity codes and MET intensities" 32 (32): 498-504, 2000

35 Roh E, "Comparison of pancreatic volume and fat amount linked with glucose homeostasis between healthy Caucasians and Koreans" 20 : 2642-2652, 2018

36 Qureshi K, "Comparative evaluation of whole body and hepatic insulin resistance using indices from oral glucose tolerance test in morbidly obese subjects with nonalcoholic fatty liver disease" 2010 : 741521-, 2010

37 Kim Y, "Cohort profile : the Korean genome and epidemiology study(KoGES)consortium" 46 : e20-, 2017

38 Contal C, "An application of changepoint methods instudying the effect of age on survival in breast cancer" 30 : 253-270, 1999

39 Centers for Disease Control and Prevention (CDC), "Adult Tobacco Use Information"

40 American Diabetes Association, "2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019" American Diabetes Association 42 (42): S13-S28, 2018