Lipids & metabolic liver disease
Temporal evolution of tissue-specific insulin resistance and transitions in MASLD status: a retrospective longitudinal cohort study
Authors' conclusion
The temporal relationships among tissue-specific IR differed according to MASLD status. Hepatic IR preceded peripheral IR in participants without MASLD, whereas more multidirectional relationships were identified in those with MASLD.
Study context
- Population
- Participants with repeated OGTT and tissue-specific insulin resistance (IR) indices assessment, June 2014–December 2025
- Participants
- 491 participants
- Exposure
- Participants without MASLD vs with MASLD at baseline
- Without MASLDn = 293
- With MASLDn = 198
- Outcome
- Temporal associations among hepatic IR, adipo-IR and muscle IR
- Follow-up
- Median interval 22 months (range, 12-32 months)
Methodological detailscross-lagged path analysis, stratified by baseline MASLD status
- Cross-lagged path analysis
- Stratified by baseline MASLD status
Main finding
As reported in the abstract
Cross-lagged associations among tissue-specific IR (fully adjusted model) · median 22 months
- Without MASLD: baseline hepatic IR → subsequent adipo-IR
- ρ1 = 0.303, P < 0.01
- Without MASLD: baseline hepatic IR → subsequent muscle IR
- ρ2 = −0.211, P < 0.001
- With MASLD: hepatic IR → subsequent muscle IR
- ρ2 = −0.195, P < 0.01
- With MASLD: adipo-IR → subsequent muscle IR
- ρ4 = −0.184, P < 0.05
- With MASLD: baseline muscle IR → subsequent hepatic IR
- ρ5 = 0.084, P < 0.05
Observational data: associations, not effects.
Further findings
MASLD status transitions · median 22 months
Baseline factors associated with persistent or progressive IR
| OR (95% CI) | P value | ||
|---|---|---|---|
| BMILogistic regression | 1.07 (1.01–1.13) | all P < 0.05 | |
| HOMA-IRLogistic regression | 1.26 (1.07–1.47) | all P < 0.05 | |
| CT attenuation valueLogistic regression | 0.97 (0.94–0.99) | all P < 0.05 | |
| 0.512Odds ratio (log scale) |
- MASLD status transitions: Without MASLD: developed MASLD; With MASLD: transitioned to elevated FIB-4 category (>1.3)
Original publication
Temporal evolution of tissue-specific insulin resistance and transitions in MASLD status: a retrospective longitudinal cohort study. Diabetes Res Clin Pract. Published 29 August 2026. doi:10.
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