Warning: fopen(/home/virtual/enm-kes/journal/upload/ip_log/ip_log_2025-05.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 100 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 101
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Changwon Fatima Hospital, Changwon, Korea
2Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Copyright © 2021 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: D.J.K. Acquisition, analysis, or interpretation of data: D.J.K., M.Y.L., I.J., S.J.M., H.K., S.E.P. Drafting the work or revising: D.J.K., E.J.R., W.Y.L. Final approval of the manuscript: D.J.K., E.J.R., W.Y.L.
Characteristic | Overall | HOMA-IR change groups | P value | |||
---|---|---|---|---|---|---|
|
||||||
G1 (<0) | G2 (0–0.50) | G3 (0.51–1.00) | G4 (>1.00) | |||
No. of participants (%) | 15,728 | 6,010 (38.2) | 3,512 (22.3) | 2,587 (16.4) | 3,619 (23.0) | |
|
||||||
Male sex | 13,531 (86.0) | 5,140 (85.5) | 3,085 (87.8) | 2,240 (86.5) | 3,066 (84.7) | 0.001 |
|
||||||
Age, yr | 40.5±6.5 | 40.7±6.4 | 40.9±6.7 | 40.5±6.4 | 39.6±6.4 | <0.001 |
|
||||||
BMI, kg/m2 | 25.8±2.8 | 25.9±2.8 | 25.2±2.6 | 25.5±2.6 | 26.4±2.9 | <0.001 |
|
||||||
Obesitya | 9,260 (58.8) | 3,618 (60.2) | 1,823 (51.9) | 1,435 (55.4) | 2,384 (65.8) | <0.001 |
|
||||||
Waist circumference, cm | 89.2±7.3 | 89.3±7.4 | 87.9±6.9 | 88.5±6.8 | 90.7±7.8 | <0.001 |
|
||||||
Fasting blood glucose, mmol/L | 5.42±0.50 | 5.53±0.52 | 5.36±0.47 | 5.33±0.48 | 5.35±0.50 | <0.001 |
|
||||||
Hemoglobin A1c, % | 5.6±0.2 | 5.6±0.2 | 5.6±0.2 | 5.6±0.2 | 5.7±0.31 | <0.001 |
|
||||||
SBP, mm Hg | 113.5±12.0 | 113.94±11.9 | 112.55±11.6 | 112.64±11.7 | 114.62±12.5 | <0.001 |
|
||||||
AST, U/L | 22 (18–28) | 22 (18–27) | 21 (18–27) | 22 (18–27) | 24 (19–31) | <0.001 |
|
||||||
ALT, U/L | 28 (20–40) | 27 (20–40) | 25 (19–37) | 26 (20–38) | 31 (22–46) | <0.001 |
|
||||||
Platelets, ×103/mm3 | 241 (212–274) | 241 (212–274) | 240 (211–272) | 242 (213–273) | 242 (212–276) | 0.056 |
|
||||||
Albumin, g/dL | 4.63±0.23 | 4.62±0.23 | 4.62±0.23 | 4.63±0.24 | 4.64±0.24 | <0.001 |
|
||||||
Total cholesterol, mmol/L | 5.38±0.89 | 5.38±0.9 | 5.35±0.88 | 5.36±0.87 | 5.4±0.91 | 0.103 |
|
||||||
Triglyceride, mmol/L | 1.57 (1.14–2.18) | 1.66 (1.20–2.28) | 1.49 (1.08–2.07) | 1.50 (1.08–2.10) | 1.56 (1.13–2.18) | <0.001 |
|
||||||
LDL-C, mmol/L | 3.52±0.81 | 3.49±0.82 | 3.51±0.79 | 3.54±0.79 | 3.57±0.83 | <0.001 |
|
||||||
HDL-C, mmol/L | 1.26±0.29 | 1.26±0.29 | 1.28±0.28 | 1.27±0.28 | 1.23±0.28 | <0.001 |
|
||||||
hs-CRP, mmol/L | 0.07 (0.04–0.13) | 0.07 (0.04–0.13) | 0.06 (0.04–0.12) | 0.07 (0.04–0.12) | 0.08 (0.04–0.15) | <0.001 |
|
||||||
Current alcohol useb | 8,219 (52.2) | 3,167 (52.7) | 1,808 (51.4) | 1,326 (51.2) | 1,918 (53.0) | 0.370 |
Male | 6,823 (50.4) | 2,618 (50.9) | 1,537 (49.8) | 1,104 (49.2) | 1,564 (51.0) | 0.463 |
Female | 1,396 (63.5) | 549 (63.1) | 271 (63.4) | 222 (63.9) | 354 (64.0) | 0.985 |
|
||||||
Smoking status | <0.001 | |||||
Never smoker | 3,839 (24.4) | 1,490 (24.7) | 838 (23.8) | 619 (23.9) | 892 (24.6) | |
Ex-smoker | 5,810 (36.9) | 2,329 (38.7) | 1,341 (38.1) | 919 (35.5) | 1,221 (33.7) | |
Current smoker | 5,189 (32.9) | 1,857 (30.9) | 1,135 (32.3) | 903 (34.9) | 1,294 (35.7) | |
|
||||||
Regular exercise | 0.231 | |||||
≥3 times/week | 1,783 (11.3) | 660 (10.9) | 434 (12.3) | 309 (11.9) | 380 (10.5) | |
<3 times/week | 13,541 (86.0) | 5,192 (86.3) | 2,990 (85.1) | 2,215 (85.6) | 3,144 (86.8) | |
|
||||||
NFS | −2.74±1.00 | −2.63±1.02 | −2.77±0.99 | −2.84±0.98 | −2.83±0.99 | <0.001 |
|
||||||
APRI | 0.24 (0.19–0.31) | 0.24 (0.19–0.31) | 0.23 (0.19–0.30) | 0.24 (0.19–0.30) | 0.26 (0.20–0.34) | <0.001 |
|
||||||
HOMA-IR | 1.72 (1.19–2.43) | 2.15 (1.57–2.94) | 1.44 (1.02–1.98) | 1.41 (0.98–1.95) | 1.64 (1.12–2.30) | <0.001 |
Values are expressed as number (%), mean±standard deviation, or median (interquartile range).
HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index; SBP, systolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein; NFS, nonalcoholic fatty liver disease (NAFLD) fibrosis score; APRI, aspartate aminotransferase to platelet ratio index.
a Obesity was defined as the BMI of ≥25 kg/m2;
b Participants with daily alcohol consumption above the median value (12 g/day for men and 2 g/day for women).
HOMA-IR change | Case (%) | Multivariate-adjusted OR (95% CI) | ||||
---|---|---|---|---|---|---|
|
||||||
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | ||
Progression (NFSa) | ||||||
G1 (<0) | 254 (4.2) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 187 (5.3) | 1.23 (1.01–1.49) | 1.24 (1.02–1.5) | 1.31 (1.05–1.63) | 1.31 (1.05–1.63) | 1.33 (1.07–1.65) |
G3 (0.51–1.00) | 156 (6.0) | 1.39 (1.13–1.71) | 1.39 (1.13–1.71) | 1.45 (1.15–1.82) | 1.44 (1.15–1.82) | 1.46 (1.16–1.83) |
G4 (>1.00) | 352 (9.7) | 2.34 (1.98–2.76) | 2.31 (1.96–2.74) | 2.26 (1.87–2.72) | 2.23 (1.85–2.69) | 2.25 (1.87–2.71) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
|
||||||
Regression (NFSa) | ||||||
G1 (<0) | 409 (6.8) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 146 (4.2) | 0.60 (0.49–0.73) | 0.60 (0.5–0.73) | 0.52 (0.41–0.65) | 0.52 (0.41–0.65) | 0.53 (0.42–0.67) |
G3 (0.51–1.00) | 80 (3.1) | 0.44 (0.35–0.57) | 0.45 (0.35–0.58) | 0.43 (0.33–0.57) | 0.43 (0.33–0.57) | 0.44 (0.33–0.58) |
G4 (>1.00) | 85 (2.4) | 0.35 (0.28–0.44) | 0.35 (0.27–0.44) | 0.33 (0.26–0.43) | 0.33 (0.25–0.43) | 0.33 (0.25–0.43) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
|
||||||
Progression (APRI) | ||||||
G1 (<0) | 194 (3.2) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 103 (2.9) | 0.80 (0.62–1.02) | 0.92 (0.72–1.17) | 0.99 (0.76–1.29) | 0.97 (0.75–1.27) | 1.14 (0.87–1.50) |
G3 (0.51–1.00) | 103 (4.0) | 0.67 (0.50–0.90) | 1.24 (0.97–1.58) | 1.29 (0.99–1.68) | 1.26 (0.97–1.65) | 1.50 (1.14–1.98) |
G4 (>1.00) | 269 (7.4) | 1.36 (1.10–1.69) | 2.39 (1.97–2.89) | 2.31 (1.88–2.84) | 2.08 (1.69–2.57) | 2.55 (2.05–3.18) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
|
||||||
Regression (APRI) | ||||||
G1 (<0) | 201 (3.3) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 95 (2.7) | 0.90 (0.71–1.15) | 0.82 (0.64–1.06) | 0.92 (0.70–1.20) | 0.91 (0.69–1.19) | 1.04 (0.79–1.37) |
G3 (0.51–1.00) | 59 (2.3) | 1.23 (0.96–1.57) | 0.69 (0.51–0.93) | 0.78 (0.57–1.07) | 0.77 (0.57–1.05) | 0.92 (0.67–1.26) |
G4 (>1.00) | 160 (4.4) | 2.42 (2.00–2.93) | 1.34 (1.09–1.66) | 1.23 (0.98–1.54) | 1.14 (0.91–1.14) | 1.39 (1.10–1.77) |
P for trend | 0.016 | 0.019 | 0.104 | 0.411 | 0.022 |
Model 1, adjusted for age, sex, and center (Seoul or Suwon); Model 2, additionally adjusted for systolic blood pressure, regular exercise, current alcohol consumption, and smoking status; Model 3, additionally adjusted for body mass index (BMI), waist circumference, and hemoglobin A1c, high-sensitivity C-reactive protein, low-density lipoprotein cholesterol, and triglyceride levels; Model 4, additionally adjusted for development of new-onset diabetes; Model 5, additionally adjusted for baseline HOMA-IR.
HOMA-IR, homeostatic model assessment of insulin resistance; OR, odds ratio; CI, confidence interval; NFS, nonalcoholic fatty liver disease (NAFLD) fibrosis score; APRI, aspartate aminotransferase to platelet ratio index.
a For the NFS analyses, the models were not adjusted for age and BMI as these factors were included in the calculation of the NFS.
Standardized quartilea | Multivariate-adjusted OR (95% CI) | |||
---|---|---|---|---|
|
||||
NFSb | APRIc | |||
|
|
|||
HOMA-IR change | BMI change | HOMA-IR change | BMI change | |
Progression | ||||
Q1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Q2 | 1.16 (0.84–1.60) | 1.21 (0.93–1.56) | 1.58 (1.09–2.29) | 1.51 (0.99–2.31) |
Q3 | 1.64 (1.19–2.28) | 1.28 (0.99–1.65) | 2.32 (1.58–3.39) | 2.78 (1.86–4.16) |
Q4 | 2.76 (1.96–3.88) | 1.56 (1.17–2.09) | 4.24 (2.86–6.29) | 8.01 (5.32–12.04) |
P for trend | <0.001 | 0.003 | <0.001 | <0.001 |
Per 1 SD increase | 1.33 (1.25–1.42) | 1.16 (1.07–1.24) | 1.38 (1.29–1.48) | 2.08 (1.90–2.28) |
|
||||
Regression | ||||
Q1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Q2 | 0.88 (0.66–1.16) | 0.9 (0.70–1.16) | 0.93 (0.67–1.28) | 0.78 (0.60–1.01) |
Q3 | 0.42 (0.30–0.57) | 0.68 (0.52–0.87) | 1.001 (0.71–1.41) | 0.56 (0.43–0.73) |
Q4 | 0.31 (0.20–0.48) | 0.52 (0.36–0.74) | 1.43 (0.99–2.07) | 0.41 (0.28–0.61) |
P for trend | <0.001 | <0.001 | 0.027 | <0.001 |
Per 1 SD increase | 0.66 (0.59–0.74) | 0.85 (0.78–0.92) | 1.10 (1.02–1.18) | 0.83 (0.76–0.90) |
AIC | 10,248.33 | 10,368.57 | 8,333.05 | 8,149.91 |
HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index; NAFLD, nonalcoholic fatty liver disease; OR, odds ratio; CI, confidence interval; NFS, NAFLD fibrosis score; APRI, aspartate aminotransferase to platelet ratio index; SD, standard deviation; AIC, Akaike information criterion.
a Standardized quartile range of HOMA-IR change: Q1, −18.71 to −1.00 (n=1,523); Q2, −1.00 to 0.36 (n=7,046); Q3, 0.36 to 1.72 (n=5,525); Q4, 1.72 to 14.16 (n=1,634). Standardized quartile range of BMI change: Q1, −8.72 to −0.95 (n=1,916); Q2, −0.95 to −0.36 (n=5,636); Q3, 0.36 to 1.66 (n=6,236); Q4, 1.67 to 9.56 (n=1,940);
b Adjused for sex, center (Seoul or Suwon), systolic blood pressure (SBP), regular exercise, current alcohol consumption, smoking status, waist circumference, HOMA-IR, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C), triglyceride, and new-onset diabetes;
c Adjused for age, sex, center (Seoul or Suwon), SBP, regular exercise, current alcohol consumption, smoking status, waist circumference, HOMA-IR, BMI, HbA1c, hs-CRP, LDL-C, triglyceride, and new-onset diabetes.
Characteristic | Overall | HOMA-IR change groups | P value | |||
---|---|---|---|---|---|---|
| ||||||
G1 (<0) | G2 (0–0.50) | G3 (0.51–1.00) | G4 (>1.00) | |||
No. of participants (%) | 15,728 | 6,010 (38.2) | 3,512 (22.3) | 2,587 (16.4) | 3,619 (23.0) | |
| ||||||
Male sex | 13,531 (86.0) | 5,140 (85.5) | 3,085 (87.8) | 2,240 (86.5) | 3,066 (84.7) | 0.001 |
| ||||||
Age, yr | 40.5±6.5 | 40.7±6.4 | 40.9±6.7 | 40.5±6.4 | 39.6±6.4 | <0.001 |
| ||||||
BMI, kg/m2 | 25.8±2.8 | 25.9±2.8 | 25.2±2.6 | 25.5±2.6 | 26.4±2.9 | <0.001 |
| ||||||
Obesity |
9,260 (58.8) | 3,618 (60.2) | 1,823 (51.9) | 1,435 (55.4) | 2,384 (65.8) | <0.001 |
| ||||||
Waist circumference, cm | 89.2±7.3 | 89.3±7.4 | 87.9±6.9 | 88.5±6.8 | 90.7±7.8 | <0.001 |
| ||||||
Fasting blood glucose, mmol/L | 5.42±0.50 | 5.53±0.52 | 5.36±0.47 | 5.33±0.48 | 5.35±0.50 | <0.001 |
| ||||||
Hemoglobin A1c, % | 5.6±0.2 | 5.6±0.2 | 5.6±0.2 | 5.6±0.2 | 5.7±0.31 | <0.001 |
| ||||||
SBP, mm Hg | 113.5±12.0 | 113.94±11.9 | 112.55±11.6 | 112.64±11.7 | 114.62±12.5 | <0.001 |
| ||||||
AST, U/L | 22 (18–28) | 22 (18–27) | 21 (18–27) | 22 (18–27) | 24 (19–31) | <0.001 |
| ||||||
ALT, U/L | 28 (20–40) | 27 (20–40) | 25 (19–37) | 26 (20–38) | 31 (22–46) | <0.001 |
| ||||||
Platelets, ×103/mm3 | 241 (212–274) | 241 (212–274) | 240 (211–272) | 242 (213–273) | 242 (212–276) | 0.056 |
| ||||||
Albumin, g/dL | 4.63±0.23 | 4.62±0.23 | 4.62±0.23 | 4.63±0.24 | 4.64±0.24 | <0.001 |
| ||||||
Total cholesterol, mmol/L | 5.38±0.89 | 5.38±0.9 | 5.35±0.88 | 5.36±0.87 | 5.4±0.91 | 0.103 |
| ||||||
Triglyceride, mmol/L | 1.57 (1.14–2.18) | 1.66 (1.20–2.28) | 1.49 (1.08–2.07) | 1.50 (1.08–2.10) | 1.56 (1.13–2.18) | <0.001 |
| ||||||
LDL-C, mmol/L | 3.52±0.81 | 3.49±0.82 | 3.51±0.79 | 3.54±0.79 | 3.57±0.83 | <0.001 |
| ||||||
HDL-C, mmol/L | 1.26±0.29 | 1.26±0.29 | 1.28±0.28 | 1.27±0.28 | 1.23±0.28 | <0.001 |
| ||||||
hs-CRP, mmol/L | 0.07 (0.04–0.13) | 0.07 (0.04–0.13) | 0.06 (0.04–0.12) | 0.07 (0.04–0.12) | 0.08 (0.04–0.15) | <0.001 |
| ||||||
Current alcohol use |
8,219 (52.2) | 3,167 (52.7) | 1,808 (51.4) | 1,326 (51.2) | 1,918 (53.0) | 0.370 |
Male | 6,823 (50.4) | 2,618 (50.9) | 1,537 (49.8) | 1,104 (49.2) | 1,564 (51.0) | 0.463 |
Female | 1,396 (63.5) | 549 (63.1) | 271 (63.4) | 222 (63.9) | 354 (64.0) | 0.985 |
| ||||||
Smoking status | <0.001 | |||||
Never smoker | 3,839 (24.4) | 1,490 (24.7) | 838 (23.8) | 619 (23.9) | 892 (24.6) | |
Ex-smoker | 5,810 (36.9) | 2,329 (38.7) | 1,341 (38.1) | 919 (35.5) | 1,221 (33.7) | |
Current smoker | 5,189 (32.9) | 1,857 (30.9) | 1,135 (32.3) | 903 (34.9) | 1,294 (35.7) | |
| ||||||
Regular exercise | 0.231 | |||||
≥3 times/week | 1,783 (11.3) | 660 (10.9) | 434 (12.3) | 309 (11.9) | 380 (10.5) | |
<3 times/week | 13,541 (86.0) | 5,192 (86.3) | 2,990 (85.1) | 2,215 (85.6) | 3,144 (86.8) | |
| ||||||
NFS | −2.74±1.00 | −2.63±1.02 | −2.77±0.99 | −2.84±0.98 | −2.83±0.99 | <0.001 |
| ||||||
APRI | 0.24 (0.19–0.31) | 0.24 (0.19–0.31) | 0.23 (0.19–0.30) | 0.24 (0.19–0.30) | 0.26 (0.20–0.34) | <0.001 |
| ||||||
HOMA-IR | 1.72 (1.19–2.43) | 2.15 (1.57–2.94) | 1.44 (1.02–1.98) | 1.41 (0.98–1.95) | 1.64 (1.12–2.30) | <0.001 |
HOMA-IR change | Case (%) | Multivariate-adjusted OR (95% CI) | ||||
---|---|---|---|---|---|---|
| ||||||
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | ||
Progression (NFS | ||||||
G1 (<0) | 254 (4.2) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 187 (5.3) | 1.23 (1.01–1.49) | 1.24 (1.02–1.5) | 1.31 (1.05–1.63) | 1.31 (1.05–1.63) | 1.33 (1.07–1.65) |
G3 (0.51–1.00) | 156 (6.0) | 1.39 (1.13–1.71) | 1.39 (1.13–1.71) | 1.45 (1.15–1.82) | 1.44 (1.15–1.82) | 1.46 (1.16–1.83) |
G4 (>1.00) | 352 (9.7) | 2.34 (1.98–2.76) | 2.31 (1.96–2.74) | 2.26 (1.87–2.72) | 2.23 (1.85–2.69) | 2.25 (1.87–2.71) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
| ||||||
Regression (NFS | ||||||
G1 (<0) | 409 (6.8) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 146 (4.2) | 0.60 (0.49–0.73) | 0.60 (0.5–0.73) | 0.52 (0.41–0.65) | 0.52 (0.41–0.65) | 0.53 (0.42–0.67) |
G3 (0.51–1.00) | 80 (3.1) | 0.44 (0.35–0.57) | 0.45 (0.35–0.58) | 0.43 (0.33–0.57) | 0.43 (0.33–0.57) | 0.44 (0.33–0.58) |
G4 (>1.00) | 85 (2.4) | 0.35 (0.28–0.44) | 0.35 (0.27–0.44) | 0.33 (0.26–0.43) | 0.33 (0.25–0.43) | 0.33 (0.25–0.43) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
| ||||||
Progression (APRI) | ||||||
G1 (<0) | 194 (3.2) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 103 (2.9) | 0.80 (0.62–1.02) | 0.92 (0.72–1.17) | 0.99 (0.76–1.29) | 0.97 (0.75–1.27) | 1.14 (0.87–1.50) |
G3 (0.51–1.00) | 103 (4.0) | 0.67 (0.50–0.90) | 1.24 (0.97–1.58) | 1.29 (0.99–1.68) | 1.26 (0.97–1.65) | 1.50 (1.14–1.98) |
G4 (>1.00) | 269 (7.4) | 1.36 (1.10–1.69) | 2.39 (1.97–2.89) | 2.31 (1.88–2.84) | 2.08 (1.69–2.57) | 2.55 (2.05–3.18) |
P for trend | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
| ||||||
Regression (APRI) | ||||||
G1 (<0) | 201 (3.3) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
G2 (0–0.50) | 95 (2.7) | 0.90 (0.71–1.15) | 0.82 (0.64–1.06) | 0.92 (0.70–1.20) | 0.91 (0.69–1.19) | 1.04 (0.79–1.37) |
G3 (0.51–1.00) | 59 (2.3) | 1.23 (0.96–1.57) | 0.69 (0.51–0.93) | 0.78 (0.57–1.07) | 0.77 (0.57–1.05) | 0.92 (0.67–1.26) |
G4 (>1.00) | 160 (4.4) | 2.42 (2.00–2.93) | 1.34 (1.09–1.66) | 1.23 (0.98–1.54) | 1.14 (0.91–1.14) | 1.39 (1.10–1.77) |
P for trend | 0.016 | 0.019 | 0.104 | 0.411 | 0.022 |
Standardized quartile |
Multivariate-adjusted OR (95% CI) | |||
---|---|---|---|---|
| ||||
NFS |
APRI | |||
|
| |||
HOMA-IR change | BMI change | HOMA-IR change | BMI change | |
Progression | ||||
Q1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Q2 | 1.16 (0.84–1.60) | 1.21 (0.93–1.56) | 1.58 (1.09–2.29) | 1.51 (0.99–2.31) |
Q3 | 1.64 (1.19–2.28) | 1.28 (0.99–1.65) | 2.32 (1.58–3.39) | 2.78 (1.86–4.16) |
Q4 | 2.76 (1.96–3.88) | 1.56 (1.17–2.09) | 4.24 (2.86–6.29) | 8.01 (5.32–12.04) |
P for trend | <0.001 | 0.003 | <0.001 | <0.001 |
Per 1 SD increase | 1.33 (1.25–1.42) | 1.16 (1.07–1.24) | 1.38 (1.29–1.48) | 2.08 (1.90–2.28) |
| ||||
Regression | ||||
Q1 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Q2 | 0.88 (0.66–1.16) | 0.9 (0.70–1.16) | 0.93 (0.67–1.28) | 0.78 (0.60–1.01) |
Q3 | 0.42 (0.30–0.57) | 0.68 (0.52–0.87) | 1.001 (0.71–1.41) | 0.56 (0.43–0.73) |
Q4 | 0.31 (0.20–0.48) | 0.52 (0.36–0.74) | 1.43 (0.99–2.07) | 0.41 (0.28–0.61) |
P for trend | <0.001 | <0.001 | 0.027 | <0.001 |
Per 1 SD increase | 0.66 (0.59–0.74) | 0.85 (0.78–0.92) | 1.10 (1.02–1.18) | 0.83 (0.76–0.90) |
AIC | 10,248.33 | 10,368.57 | 8,333.05 | 8,149.91 |
Values are expressed as number (%), mean±standard deviation, or median (interquartile range). HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index; SBP, systolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein; NFS, nonalcoholic fatty liver disease (NAFLD) fibrosis score; APRI, aspartate aminotransferase to platelet ratio index. Obesity was defined as the BMI of ≥25 kg/m2; Participants with daily alcohol consumption above the median value (12 g/day for men and 2 g/day for women).
Model 1, adjusted for age, sex, and center (Seoul or Suwon); Model 2, additionally adjusted for systolic blood pressure, regular exercise, current alcohol consumption, and smoking status; Model 3, additionally adjusted for body mass index (BMI), waist circumference, and hemoglobin A1c, high-sensitivity C-reactive protein, low-density lipoprotein cholesterol, and triglyceride levels; Model 4, additionally adjusted for development of new-onset diabetes; Model 5, additionally adjusted for baseline HOMA-IR. HOMA-IR, homeostatic model assessment of insulin resistance; OR, odds ratio; CI, confidence interval; NFS, nonalcoholic fatty liver disease (NAFLD) fibrosis score; APRI, aspartate aminotransferase to platelet ratio index. For the NFS analyses, the models were not adjusted for age and BMI as these factors were included in the calculation of the NFS.
HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index; NAFLD, nonalcoholic fatty liver disease; OR, odds ratio; CI, confidence interval; NFS, NAFLD fibrosis score; APRI, aspartate aminotransferase to platelet ratio index; SD, standard deviation; AIC, Akaike information criterion. Standardized quartile range of HOMA-IR change: Q1, −18.71 to −1.00 ( Adjused for sex, center (Seoul or Suwon), systolic blood pressure (SBP), regular exercise, current alcohol consumption, smoking status, waist circumference, HOMA-IR, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C), triglyceride, and new-onset diabetes; Adjused for age, sex, center (Seoul or Suwon), SBP, regular exercise, current alcohol consumption, smoking status, waist circumference, HOMA-IR, BMI, HbA1c, hs-CRP, LDL-C, triglyceride, and new-onset diabetes.