Association between severity of nonalcoholic fatty liver disease and insulin resistance in a South Asian tertiary care cohort

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome associated with insulin resistance and dysglycemia. This hospital-based cross-sectional study enrolled 104 ultrasound-confirmed NAFLD patients from a tertiary care center in India. NAFLD severity was graded ultrasonographically; insulin resistance was quantified using Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Insulin resistance was detected in 83.6%. Mean HOMA-IR increased across grades (3.31 ± 0.72, 4.51 ± 0.88, and 6.98 ± 0.42; P < 0.001). Glucose intolerance was present in 80.7%. Grade 3 NAFLD remained significantly associated with dysglycemia in adjusted exploratory analysis (adjusted odds ratio: 6.47, 95% confidence interval: 1.73–24.2, P = 0.005). These findings support routine glucose screening in NAFLD patients with higher ultrasound grades.