INSULIN RESISTANCE AS AN INDICATOR OF DIFFERENTIATION FOR THE FORMATION OF RISK GROUPS FOR NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITHOUT TYPE 2 DIABETES MELLITUS, AS A PART OF ONTOLOGICAL MODEL OF NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

The aim: Using cluster analysis, to identify a high-risk group for NAFLD and develop a differential approach to examination, treatment and prevention of the disease based on IR indices, among NAFLD and non-NAFLD patients without type 2 diabetes mellitus (T2DM). Materials and methods: Clinical, anthropometric, laboratory methods, ultrasound, computational and statistical techniques were applied. Results: Cluster analysis was performed on the laboratory tests results: glucose, insulin, HOMA-IR index, HOMA2 Calculator (%B – beta-cell function, %S – insulin sensitivity, IR – insulin resistance). 5 groups of patients were formed, according to increasing HOMA-IR index and IR. Group II was found to be transient in IR formation, it included the majority of non-NAFLD patients (87%), and we consider it to be the risk group for NAFLD. Group V – with the highest IR scores, where 92% of patients had NAFLD and 73% had a high Fatty Liver Index – is considered to be a very high-risk group for developing T2DM. Conclusions: 1. According to the results of cluster analysis, 5 groups of patients with different IR levels were identified. 2. In the second group, where non-NAFLD patients predominate, insulin resistance begins to form. 3. Groups III and IV – patients with high HOMA-IR index – had significant ultrasound findings indicating hepatic steatosis. 4. Group V included patients with NAFLD, with high HOMA-IR index and the highest risk of developing T2DM.