ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1623808
This article is part of the Research TopicHot Topics in Diabetes and Steatotic Liver DiseaseView all 14 articles
ISImatsuda as a Potential Predictor of Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Type 2 Diabetes Mellitus
Provisionally accepted
Jing Liu1,2
Yueqiu Wang2Xinghang Zhou3Zaixin Wen3Yu Chen3Yiqiong Sun2Shuaiying Su4Weiwei Lin5
Ruiting Shen2Xiaoyu Sun3Hongru Li3Xia Yu3
Mingchen Zhang1,2*- 1Wenzhou Medical University, Wenzhou, China
- 2Ningbo No. 2 Hospital, Ningbo, China
- 3Northeastern University, Shenyang, China
- 4Shaoxing University, Shaoxing, China
- 5Zhejiang Chinese Medical University, Hangzhou, China
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This study aimed to determine the most efficacious insulin resistance (IR) indices to predict metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM).This cross-sectional study included 1,587 patients with T2DM. MASLD was defined by abdominal ultrasound findings. Liver fibrosis risk was assessed with FIB-4. All participants underwent a 100 g standard steamed bread meal test. We analyzed basal IR indices (HOMA-IR, QUICKI, IAI, Bennett ISI) and post-stimulation IR indices (ISImatsuda, ISI0,120) to explore their associations with MASLD and liver fibrosis.Participants were categorized into four groups according to IR indices quartiles. Among post-stimulation IR indices, MASLD detection rates in ISImatsuda Q1-Q4 groups were 65.7%, 54.2%, 37.0%, and 22.2%, respectively. Logistic regression analysis revealed significantly increased odds ratios (ORs) for MASLD in ISImatsuda Q1-Q3 groups compared to the Q4 group (OR = 3.63, 2.53, and 1.53, respectively; all p < 0.05).Similar results were observed across other IR indices (all p < 0.05). There were no statistically significant differences in the detection rates of liver fibrosis or the ORs among the quartile groups of the IR indices (all p > 0.05). ROC curve analysis showed that ISImatsuda had superior predictive power for MASLD in patients with T2DM (AUC = 0.701). Based on these findings, a risk prediction model for MASLD in the T2DM population was constructed using age, body mass index (BMI), alanine aminotransferase (ALT), triglycerides (TG), and 2-hour postprandial C-peptide (2h CP).Among the IR indices, ISImatsuda demonstrated the strongest correlation and highest predictive value for MASLD in T2DM.
Keywords: Insulin Resistance, Matsuda index, metabolic dysfunction associated steatotic liver disease, type 2 diabetes mellitus, liver fibrosis
Received: 06 May 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Liu, Wang, Zhou, Wen, Chen, Sun, Su, Lin, Shen, Sun, Li, Yu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingchen Zhang, Wenzhou Medical University, Wenzhou, China
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