THE ASSOCIATION BETWEEN INSULIN AND LIVER DISEASE

Abstract

Introduction: Over the past three decades, the prevalence of diabetes has steadily increased. Additionally, diabetes has contributed to more diagnosed cases of liver disease (LD) suggesting that liver health is increasingly vulnerable to insulin levels. Several studies have found that endogenous insulin levels were important indicators in the development and progression of LD. However, to our knowledge, no studies have assessed the association of exogenous insulin intake and LD. Methods: Using nationally representative data from the 2013-2014 (n=5769) and 2015-2016 (n=5719) National Health and Nutrition Examination Survey, this study assessed the association between exogenous insulin use and liver disease as well as duration of insulin use. Descriptive statistics were calculated. Sex and race were tested as potential effect modifiers of the relationship between taking insulin and insulin duration and LD and multivariable logistic regression models were run. Results: Overall, participants were about 52% female in 2013-2014 and 2015-2016 with an average age of 47.5. Ever taking insulin was significantly positively associated with having a current liver condition in 2013-2014 (OR: 3.12; 95% CI: 1.06-9.23) and 2015-2016 (OR=4.16; 95% CI: 1.10-15.8). Respondents in cycle 2013-2014 taking insulin for five or more years had significantly greater odds of having a current liver condition (OR 3.26; 95% CI: 1.08-9.84) compared to taking insulin for zero years. Sex and race were effect modifiers for the duration of insulin intake in cycle 2015-2016, however due to the small sample sizes stratification was not performed. Conclusion: Taking insulin and duration of insulin intake is positively associated with participants having a current liver condition. This finding suggests that further increases in the prevalence of diabetes will impact the prevalence of liver conditions and ultimately increase related healthcare costs and decrease quality of life.