{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:51:42Z","timestamp":1786366302864,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,2,3]],"date-time":"2019-02-03T00:00:00Z","timestamp":1549152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["17K09437"],"award-info":[{"award-number":["17K09437"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Although non\u2010alcoholic fatty liver disease (NAFLD) is common in the general population, identifying patients with advanced fibrosis remains a challenge. We investigated whether the homeostasis model assessment parameter of insulin resistance (HOMA\u2010IR), an index of IR and one of the most important metabolic factors, is an independent predictive factor for advanced fibrosis in nondiabetic patients with NAFLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, cross\u2010sectional multicenter study. We included 361 patients with biopsy\u2010proven NAFLD who had not been diagnosed with type 2 diabetes mellitus: 175 (48%) were women and 48 (13%) had advanced fibrosis. We used simple random sampling; the sampling ratio of the estimation and validation groups was 7:3. A logistic model was constructed for both the estimation and validation groups. The explanatory variables were age \u2265\u00a049\u00a0years, sex (women), body mass index \u2265\u00a026.7\u00a0kg\/m<jats:sup>2<\/jats:sup>, the presence of hypertension, presence of dyslipidemia, fasting plasma glucose level\u00a0\u2265\u00a098\u00a0mg\/dL, fasting immune reactive insulin level\u00a0\u2265\u00a012.0\u00a0\u03bcU\/mL, and HOMA\u2010IR\u00a0\u2265\u00a02.90. The median HOMA\u2010IR of the patients was 2.88 (interquartile range: 2.1\u20134.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the estimation group, univariate and multivariate analyses showed that age, dyslipidemia, and HOMA\u2010IR were independent predictors of advanced fibrosis. In the validation group, only age and HOMA\u2010IR were found to be independent predictors of advanced fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Homeostasis model assessment parameter of insulin resistance was an independent predictor of advanced liver fibrosis in nondiabetic patients with NAFLD. Given that most patients with NAFLD are nondiabetic, it is important to set goals with respect to improving IR to subsequently reduce liver fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14595","type":"journal-article","created":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T04:34:19Z","timestamp":1546403659000},"page":"1390-1395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["<scp>HOMA\u2010IR<\/scp>: An independent predictor of advanced liver fibrosis in nondiabetic non\u2010alcoholic fatty liver disease"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-9623","authenticated-orcid":false,"given":"Hideki","family":"Fujii","sequence":"first","affiliation":[{"name":"Department of Hepatology Osaka City University  Osaka Japan"},{"name":"Endowed Department of Liver Cirrhosis Therapeutics, Graduate School of Medicine Osaka City University  Osaka 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