Hepatic insulin resistance (IR) contributes to metabolic dysregulation in type 2 diabetes mellitus (T2DM), yet its clinical phenotype remains incompletely defined. A cross-sectional analysis published in Frontiers in Endocrinology evaluated metabolic characteristics associated with the Hepatic Insulin Resistance Index (HIRI) in individuals with T2DM.

The study included 2,475 Korean adults with T2DM from the Korean National Diabetes Program cohort. Participants were categorized into HIRI tertiles based on oral glucose tolerance test results. Associations between HIRI and anthropometric measures, glycemic parameters, lipid profiles, liver function markers, and dietary intake were assessed. Logistic regression models evaluated the relationship between HIRI and dyslipidemia and metabolic syndrome components after adjustment for confounders.

Participants with higher HIRI had greater central obesity, with higher waist circumference (90.92 vs 85.52 cm; p<0.0001). Glycemic patterns differed across groups, with higher fasting glucose (153.26 vs 147.53 mg/dL; p<0.0001) but lower postprandial glucose (273.73 vs 299.32 mg/dL; p=0.0001) and glycated hemoglobin (HbA1c) levels (7.8% vs 8.2%; p=0.0026).

Higher HIRI was also associated with dyslipidemia, including elevated triglycerides (190.71 vs 141.41 mg/dL; p<0.0001) and lower high-density lipoprotein cholesterol (HDL-C) levels (45.29 vs 48.40 mg/dL; p<0.0001).

These findings describe a metabolic pattern associated with higher HIRI in T2DM, characterized by central obesity, altered glycemic parameters, and atherogenic lipid profiles. This profile may support risk stratification in clinical practice.