Evaluating liver fibrosis: the role of elastography and FibroTest in patients with non-alcoholic fatty liver disease and insulin resistance

Background. Non-Alcoholic Fatty Liver Disease (NAFLD), a common chronic liver disease, is often associated with Insulin Resistance (IR), which accelerates fibrosis progression. As NAFLD prevalence rises, understanding IR's role in liver damage is crucial. Non-invasive methods like elastography and FibroTest help assess fibrosis severity but remain underexplored in NAFLD patients with IR. Aim. To compare liver elastography and FibroTest results in patients with isolated non-alcoholic fatty liver disease and NAFLD with insulin resistance, assessing fibrosis differences and the effect of comorbidity on disease progression. Materials and Methods. NAFLD patients were divided into two groups: isolated NAFLD, and NAFLD with IR. Liver stiffness was measured via elastography, fibrosis levels via FibroTest, and laboratory markers (including ALanineaminoTransferase (ALT), ASpartateaminoTransferase (AST), protein metabolism) were analyzed to evaluate liver function Results. Patients with NAFLD and IR had significantly higher elastography values (10.5 kPa vs. 6.2 kPa in isolated NAFLD). ALT and AST levels were elevated in the IR group (ALT 65 U/L, AST 59 U/L), while protein metabolism indicators were lower, reflecting greater liver dysfunction. Strong correlations were found between elastography and ALT (r=0.844) and AST (r=0.822). FibroTest scores were higher in the IR group (0.78 vs. 0.58 in isolated NAFLD), indicating more advanced fibrosis. Conclusions. IR accelerates fibrosis in NAFLD, with elastography and FibroTest effectively differentiating fibrosis severity. These findings support their use in clinical practice for improved assessment and management, particularly in NAFLD patients with IR. Further research is needed to refine treatment strategies. Keywords: steatosis, metabolic syndrome, sheer-wave elastography, MAFLD.