Poor correlation between HOMA index and Triglycerides/HDL-C ratio as markers of insulin resistance in adult patients with MAFLD.

Introduction and Objectives

In children, studies have demonstrated that Triglycerides/HDL-C ratio can be a good alternative to the HOMA index for measuring insulin resistance as a more accessible and widely available method in MAFLD. However, this has not been replicated in adults. Our goal is to show the correlation that exists between the HOMA index and the Triglycerides (TG) to High-Density Lipoprotein (HDL) ratio as markers of insulin resistance in adult patients with fatty liver disease.

Materials and Patients

Descriptive and retrospective study. It included 80 adult patients with MAFLD between July 2021 and May 2023. Insulin resistance (RI) was defined as a HOMA index ≥2.71 or a TG/HDL-C ratio ≥1.36 mmol/L. The results were analyzed using measures of central tendency, dispersion, and Pearson´s test.

Results

80 patients were evaluated, with 65% of the sample corresponding to women, with a mean age of 52.5 years. 64% of patients (n=51) with MAFLD showed insulin resistance measured by HOMA-IR, while 57.7% (n=46) had a Trigl/HDL-C ratio ≥1.36. 8 patients who showed extreme data, possibly due to laboratory measurement error, were excluded. When applying the Pearson´s test, a score of 0.25 was obtained, indicating a weak correlation between both markers (Table 1 and Figure 1).

Conclusions

In our study, we found a low correlation between the HOMA index and the Triglycerides/HDL-C ratio, suggesting that the Triglycerides/HDL-C ratio may not be a suitable marker for insulin resistance in adult patients with MAFLD. Therefore, we do not currently recommend its use in this patient population.

Ethical statement

The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.

Declaration of interests

None

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figure 1. Simple scatter plot with HOMA index line fit by TG-HDL ratio.

Table 1. Correlation between HOMA and Triglycerides/HDL-C ratio using Pearson´s test.