Insulin resistance, not hepatic histological features, is the dominant correlate of insulin clearance in class 3 obesity
Authors' conclusion
In class 3 obesity, insulin resistance rather than hepatic histological features was the strongest independent correlate of systemic insulin clearance.
Study context
- Population
- Adults without diabetes with class 3 obesity undergoing bariatric surgery (57 % prediabetes; 81 % female; median age 40 years; BMI 46 kg/m²); 75-g OGTT and intraoperative liver biopsy
- Participants
- 69 adults
- Outcome
- Systemic insulin clearance (CLINS), from C-peptide-deconvolution-derived insulin secretion rates, in relation to liver histology
Methodological detailswithin the BARIA_DDZ cohort
- Within the BARIA_DDZ cohort
Main finding
As reported in the abstract
Correlates of systemic CLINS
- No histological parameter correlated with CLINS (hepatic lipid content, steatosis grade, lobular inflammation, ballooning, fibrosis stage, NAFLD activity score)
- all P > 0.15
- HOMA-IR independently predicted CLINS (multivariable regression)
- B = - 0.101, P = 0.005
- Oral glucose insulin sensitivity independently predicted CLINS (multivariable regression)
- B=+0.0070, P = 0.001
Observational data: associations, not effects.
Further findings
Liver histology
%
- No MASLD
- 33
- MASL
- 23
- MASH
- 44
Original publication
Insulin resistance, not hepatic histological features, is the dominant correlate of insulin clearance in class 3 obesity. Diabetes Res Clin Pract. Published 2 August 2026. doi:10.
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