Lipids & metabolic liver disease
Association of four insulin resistance indices with liver‐related adverse outcomes: A prospective cohort study
Authors' conclusion
Dynamic changes in IR indices are independently associated with liver-related adverse outcomes. Among these indices, LAP showed relatively stronger discriminative performance in females. Collectively, these indices may have potential utility as non-invasive markers for liver disease risk stratification.
Study context
- Population
- UK Biobank participants with insulin resistance (IR) indices calculated at two surveys (2006–2010 and 2012–2013)
- Exposure
- Change patterns and cumulative averages of IR indices
- Outcome
- Liver-related adverse outcomes: liver disease, MALO and MASLD (ICD-10 codes)
- Follow-up
- Mean 9.7 years
Methodological detailsK-means clustering of change patterns, cumulative average exposure
- K-means clustering of change patterns
- Cumulative average exposure
Main finding
As reported in the abstract
Liver-related adverse outcomes by eGDR change pattern
Persistently high eGDR vs Persistently low eGDRHazard ratio (95% CI)
Liver disease
0.52(0.35–0.77)
MALO
0.30(0.19–0.49)
MASLD
0.31(0.17–0.55)
- Persistently high TyG, metabolic score for insulin resistance (METS-IR) and lipid accumulation product (LAP) associated with increased risks of liver-related adverse outcomes; METS-IR strongest for MASLD (HR)
- 10.50, 4.00-27.58
Observational data: associations, not effects.
Further findings
Cumulative IR indices and liver-related adverse outcomes
- Cumulative estimated glucose disposal rate (eGDR) inversely associated (per 1 SD increase, hazard ratios (HRs) range)
- 0.52 to 0.68
- Cumulative TyG, METS-IR and LAP positively associated; METS-IR strongest link to MASLD (HR)
- 1.70, 1.48-1.96
Discriminative performance (ROC)
- LAP highest discriminative performance, particularly in females and those under 60; AUC for major adverse liver outcomes (MALO) in females up to
- 0.813
Original publication
Association of four insulin resistance indices with liver‐related adverse outcomes: A prospective cohort study. Diabetes Obes Metab. Published 3 February 2026. doi:10.
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