HOMA-IR Identified as Independent Predictor of Liver Fibrosis in MAFLD, suggests study
According to a recent study published in Scientific Reports insulin resistance as assessed by the homeostatic model assessment for insulin resistance (HOMA-IR) has been identified as an independent predictor of substantial liver fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD) patients. This observation underscores the significance of adding HOMA-IR to the criteria recently suggested metabolic dysfunction-associated steatotic liver disease (MASLD) eliminating HOMA-IR as a criterion for metabolic dysregulation. In this analysis, HOMA-IR was robustly linked with severe stages of liver fibrosis, regardless of diabetes status or body mass index (BMI). The study was conducted by Yasser F. and colleagues.
This was a cross-sectional multicenter study of 364 patients diagnosed with MAFLD. Multiple logistic regression analysis was employed to study the correlation between HOMA-IR and significant fibrosis, i.e., F ≥ 2. Fibrosis was assessed with two non-invasive techniques: the FIB-4 score and LSM. Correlation between rising insulin resistance and risk of fibrosis was correlated in different patient populations, viz., diabetic, non-diabetic, lean, and non-lean populations.
Results
The analysis showed that every unit increase in HOMA-IR equated to a 16% greater probability of important fibrosis when measured by non-invasive scoring, regardless of BMI and diabetes status.
In non-diabetic patients, HOMA-IR was independently linked with important fibrosis (OR: 1.14, 95% CI: 1.07–1.21, P < 0.001).
In diabetic patients, the association was also present (OR: 1.03, 95% CI: 1.00–1.06, P = 0.03).
In lean patients, HOMA-IR predicted fibrosis with an odds ratio of 1.06 (95% CI: 1.01–1.12, P = 0.03).
In non-lean patients, the association remained strong (OR: 1.04, 95% CI: 1.02–1.07, P < 0.001).
Overall, HOMA-IR consistently demonstrated predictive value for significant liver fibrosis across all subgroups.
The research proved that HOMA-IR is an independent predictor of severe fibrosis in MAFLD patients regardless of diabetes or BMI status. Adding HOMA-IR to the diagnostic and prognostic assessment of fatty liver patients would enhance early detection and risk stratification. Researchers underscored that HOMA-IR must be acknowledged as a vital disease progression marker and added to clinical practice.
Reference:
Fouad Y, Pan Z, Nafady S, et al. HOMA-IR, an independent predictor of advanced liver fibrosis in metabolic-dysfunction associated fatty liver disease: a cross-sectional study in Egyptian patients. Sci Rep. 2025;15(1):31098. Published 2025 Aug 24. doi:10.1038/s41598-025-15425-7
