Abstract
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as a major cause of chronic liver disease, especially in obese individuals. Insulin resistance is a key pathophysiological mechanism linking obesity to NAFLD. METHODS: This cross-sectional study was conducted in 240 obese adults (BMI ≥ 30 kg/m²) attending a tertiary care center. NAFLD was diagnosed using abdominal ultrasonography. Fasting plasma glucose (FPG), fasting insulin, and lipid profiles were measured. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR). Statistical analysis included independent t-tests, chi-square tests, and Pearson correlation, with P < 0.05 considered significant. RESULTS: The mean age was 44.2 ± 10.6 years, and 58.3% were women. NAFLD was diagnosed in 152 patients (63.3%). Patients with NAFLD had significantly higher BMI (34.7 ± 3.8 kg/m² vs. 32.5 ± 3.1 kg/m², P < 0.001), waist circumference (108.2 ± 9.5 cm vs. 102.6 ± 8.8 cm, P < 0.001), fasting insulin (18.6 ± 6.2 µIU/mL vs. 12.9 ± 4.7 µIU/mL, P < 0.001), and HOMA-IR (4.2 ± 1.6 vs. 2.8 ± 1.2, P < 0.001). A positive correlation was observed between HOMA-IR and hepatic steatosis grade (r = 0.61, P < 0.001). CONCLUSION: NAFLD prevalence in obese patients was high and strongly associated with insulin resistance markers. Early screening and targeted lifestyle or pharmacological interventions are warranted to reduce metabolic and hepatic complications.