The association between food insulin index and odds of non-alcoholic fatty liver disease (NAFLD) in adults: a case-control study

This research aimed to study the association of food insulin index and biochemical parameters with the odds of developing NAFLD in adult Iranians.

Hyperinsulinemia may play an important role in the development of non-alcoholic fatty liver disease (NAFLD) because of the relationship between insulin response and body fat accumulation.

A case-control study of 169 NAFLD patients and 200 healthy adults aged 18-55 years was conducted. Dietary data was collected using a validated 168-item quantitative food frequency questionnaire (FFQ). Food insulin index (FII) was calculated by dividing the total insulin load by total energy intake (kcal/day). Total insulin load (ILoverall) was also calculated using a standard formula.

Mean participant age was 43.9 ± 5.9 years .Patients with NAFLD were significantly associated with higher body mass index, levels of liver enzymes, triglyceride, low density lipoprotein-cholesterol (LDL), total cholesterol, and fasting blood sugar (FBS) compared to the healthy subjects (p < 0.05). The highest tertiles of FII were associated with higher odds of NAFLD (OR=1.4, 95% CI: 0.88-2.48, p for trend <0.001) and obesity (OR=2.33, 95% CI: 0.97-5.75) compared to the lowest tertiles. Potential confounders for the association were controlled.

This study found that adherence to a diet with high FII was associated with greater odds of NAFLD and overweight or obesity. Additional studies are required to better understand this association.