{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:44:27Z","timestamp":1788443067443,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T00:00:00Z","timestamp":1697328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Insulin resistance (IR) plays a pivotal role in the pathogenesis of Metabolic dysfunction\u2010Associated Fatty Liver Disease (MAFLD), which can progress to liver fibrosis. We examined the relationship of different IR scores with markers of MAFLD severity in obese individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective observational study, 346 non\u2010diabetic, overweight\/obese individuals with newly diagnosed MAFLD (age 50.2\u00a0\u00b1\u00a013.3\u00a0years, 34% females, BMI 30.8\u00a0\u00b1\u00a04.4\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) underwent liver stiffness (LS) and controlled attenuation parameter (CAP) measurements by Fibroscan\u00ae to assess liver fibrosis and steatosis. Biochemical data were collected to calculate surrogate markers of IR (Homoeostasis model assessment \u2010 insulin resistance index [HOMA\u2010IR], triglyceride\u2010glucose index, triglyceride by HDL ratio), liver fibrosis (Nonalcoholic Fatty Liver Diseases fibrosis score, fibrosis\u20104 score, Aspartate aminotransferase to platelet ratio index) and steatosis (fatty liver index, hepatic steatosis index).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All three IR scores were associated with CAP, while only HOMA\u2010IR positively correlated with LS (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.275,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), independent of age and sex, BMI, transaminases, and fibrosis markers. Insulin\u2010resistant individuals (HOMA\u2010IR &gt;2.5,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0165) had higher liver enzymes, CAP and LS, with a 4\u2010fold increased risk of severe liver disease (LS\u00a0&gt;9.7\u00a0kPa, OR 4.42[1.95\u201310.01],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0002). Among HOMA\u2010IR components, fasting plasma insulin (FPI) was independently associated with LS (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.270,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). ROC AUC for HOMA\u2010IR and FPI to predict severe liver disease were virtually identical (0.748 and 0.758, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HOMA\u2010IR is independently associated with non\u2010invasive markers of MAFLD severity in overweight\/obese individuals. This relationship is largely mediated by hyperinsulinemia, regardless of BMI. Measuring insulin levels in MAFLD individuals might be useful to identify those at risk of liver fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.3736","type":"journal-article","created":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T13:33:26Z","timestamp":1697376806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Simple proxies of insulin resistance identify obese metabolic dysfunction\u2010associated fatty liver disease subjects with advanced liver disease"],"prefix":"10.1002","volume":"40","author":[{"given":"Giovanni","family":"Petralli","sequence":"first","affiliation":[{"name":"Department of Surgical Medical, Molecular and Critical Area Pathology University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Salvati","sequence":"additional","affiliation":[{"name":"Hepatology Unit Azienda Ospedaliero Universitaria Pisana  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Tric\u00f2","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7916-5080","authenticated-orcid":false,"given":"Gabriele","family":"Ricco","sequence":"additional","affiliation":[{"name":"Hepatology Unit Azienda Ospedaliero Universitaria Pisana  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Colombatto","sequence":"additional","affiliation":[{"name":"Hepatology Unit Azienda Ospedaliero Universitaria Pisana  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizia Rossana","family":"Brunetto","sequence":"additional","affiliation":[{"name":"Hepatology Unit Azienda Ospedaliero Universitaria Pisana  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7855-8253","authenticated-orcid":false,"given":"Anna","family":"Solini","sequence":"additional","affiliation":[{"name":"Department of Surgical Medical, Molecular and Critical Area Pathology University of Pisa  Pisa 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