Adipokines and adiposity indices as predictors of glycemic status, insulin resistance, and metabolic dysfunction-associated steatotic liver disease in apparently healthy adults

Abnormal serum adipokines such as Leptin and Adipokines, are linked to metabolic diseases, insulin resistance, and fatty liver. Obesity indices like body mass index, waist-to-height ratio, waist-to-hip ratio, and fat percentage are also associated but with debate accuracy. Fat distribution, measured with visceral (VAT) and subcutaneous adipose tissue (SAT) via ultrasound, may provide more precise assessment. However, no study has yet evaluated all these parameters together. This study aims to assess the association of serum adiponectin, leptin, obesity indeces, and fat distribution with glycemic status, insulin resistance, and fatty liver and to identify the strongest independent predictors among these factors in apparently healthy adults. In an observational cross-sectional study, sixty-five apparently healthy adults participated after providing written informed consent. Following an overnight fast, detailed questionnaires, anthropometric measurements (including waist-to-height ratio), and blood samples for adiponectin, leptin, fasting glucose, insulin, and HbA1c were collected. Abdominal ultrasound was used to assess visceral and subcutaneous fat and detect fatty liver. Correlations between variables were analyzed, and multiple linear regression identified independent predictors of fatty liver and insulin resistance. A P-value of .05 was considered significant. Participants were divided into 2 age groups: young (35%) with a mean age of 33.45 years, and middle-aged (65%) with a mean age of 50.19 years. Fatty liver was present in over 30% of seemingly healthy adults. The young group had significantly higher waist/height and VAT/SAT ratios compared to the middle-aged group. In the middle-aged group, VAT, SAT, and waist/height ratio were significant independent predictors of HbA1c, with VAT being the sole significant predictor of HOMA-IR. Age and waist/height ratio were the only significant independent predictors of fatty liver. Although age and leptin were significantly correlated with HbA1c in the young group, they did not predict it. Additionally, adiponectin and leptin had no correlation with insulin resistance or the presence of fatty liver. Among the measured parameters in the middle-age group, VAT was the most significant independent predictor of insulin resistance, while the VAT/SAT ratio and waist/height ratio were key predictors of HbA1c. Age and waist/height ratio were the primary predictors of fatty liver.