Frequency of Insulin Resistance in Overweight Patients With Metabolic‐Associated Fatty Liver Disease ( MAFLD ) at a Tertiary Healthcare Centre in Bangladesh

BACKGROUND: In Bangladesh, the prevalence of MAFLD patients is about 33.86%. Most of the patients with MAFLD are also strongly associated with hepatic and adipose tissue insulin resistance (IR). Homeostasis model assessment of insulin resistance (HOMA-IR) is a simple and useful method for evaluating insulin resistance and β cell function. METHODS: This observational cross-sectional study was carried out in the outpatient department of Hepatology, Bangladesh Medical University. The subjects were non-alcoholic overweight patients with sonographic evidence of fatty liver disease aged 18 years or above. Participants were subjected to a pre-designed questionnaire including personal data. Assessment of medical history, physical examinations and investigations to measure IR were performed. Statistical analyses were carried out by using the SPSS version PC 26.0. RESULTS: The Majority of the participants, precisely 60% (95% confidence interval [CI]: 45.2, 73.6) had insulin resistance (IR) and median HOMA-IR index was 2.85. Patients with acanthosis nigricans had significantly higher IR biochemically (Mean HOMA-IR index; 5.79 vs. 2.89), which was significant statistically. No significant correlation was observed between HOMA-IR and alternative metabolic markers, including METS-IR, TG/HDL-c ratio and BMI. CONCLUSION: A high frequency (60%) of insulin resistance was found among overweight, non-diabetic patients with MAFLD. This finding underscores the immense value of regular screening for hyperglycemia in this population. With the increasing burden of metabolic syndrome, early identification of IR would enable timely preventive interventions-potentially slowing the progression to type 2 diabetes and consequently reducing subsequent risk of developing diabetes-related complications.