Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study
BackgroundBinge drinking (BD) and obesity are well-established risk factors for liver enzyme abnormalities, but how varying intensities of BD interact with obesity to affect liver function remains unclear. This study aims to examine whether insulin resistance (IR) mediates the associations between d...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1554392/full |
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| author | Jiayi Zhu Jiayi Zhu Jiayi Zhu Yinglong Duan Ying Li Yi Zhou Zitong Lu Nandan Chen Juan Luo Xingxing Wang Xiaoqian Dong Andy S. K. Cheng Yuan Liu |
| author_facet | Jiayi Zhu Jiayi Zhu Jiayi Zhu Yinglong Duan Ying Li Yi Zhou Zitong Lu Nandan Chen Juan Luo Xingxing Wang Xiaoqian Dong Andy S. K. Cheng Yuan Liu |
| author_sort | Jiayi Zhu |
| collection | DOAJ |
| description | BackgroundBinge drinking (BD) and obesity are well-established risk factors for liver enzyme abnormalities, but how varying intensities of BD interact with obesity to affect liver function remains unclear. This study aims to examine whether insulin resistance (IR) mediates the associations between different levels of BD, obesity, their interaction, and liver enzyme abnormalities.MethodsThis cross-sectional study included 137,878 young and middle-aged adults who underwent physical examinations in southern China between August 2017 and March 2024. BD was self-reported, and IR was assessed using the triglyceride–glucose (TyG) index. Causal mediation analysis within the counterfactual framework was used to quantify the mediating role of the TyG index in the associations involving BD intensity, obesity, their interaction, and liver enzyme abnormalities.ResultsThe interaction between obesity and high-intensity binge drinking (HIBD) was significantly associated with liver enzyme abnormalities (OR, 1.591; 95% CI, 1.401–1.806). IR, measured by the TyG index, statistically accounted for 36.6% (OR, 1.034; 95% CI, 1.029–1.039) of this association, exceeding the proportion explained in the HIBD alone (25.9%) or obesity alone (16.7%) pathways. No significant mediating effect of IR was observed for non-BD or low-intensity BD, regardless of obesity status.ConclusionThe TyG index serves as a critical mediator in the synergistic effects of HIBD and obesity on liver enzyme abnormalities. Targeting IR and reducing the intensity of alcohol consumption may help mitigate liver injury in young and middle-aged adults with obesity. |
| format | Article |
| id | doaj-art-9168ed4af1284444bdb4fc930893f059 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-9168ed4af1284444bdb4fc930893f0592025-08-20T03:56:00ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-07-011210.3389/fnut.2025.15543921554392Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional studyJiayi Zhu0Jiayi Zhu1Jiayi Zhu2Yinglong Duan3Ying Li4Yi Zhou5Zitong Lu6Nandan Chen7Juan Luo8Xingxing Wang9Xiaoqian Dong10Andy S. K. Cheng11Yuan Liu12Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaNursing Department, The Third Xiangya Hospital, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaNursing Department, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaNursing Department, The Third Xiangya Hospital, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaXiangya Nursing School, Central South University, Changsha, ChinaSchool of Health Sciences, Western Sydney University, Sydney, NSW, AustraliaDepartment of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, ChinaBackgroundBinge drinking (BD) and obesity are well-established risk factors for liver enzyme abnormalities, but how varying intensities of BD interact with obesity to affect liver function remains unclear. This study aims to examine whether insulin resistance (IR) mediates the associations between different levels of BD, obesity, their interaction, and liver enzyme abnormalities.MethodsThis cross-sectional study included 137,878 young and middle-aged adults who underwent physical examinations in southern China between August 2017 and March 2024. BD was self-reported, and IR was assessed using the triglyceride–glucose (TyG) index. Causal mediation analysis within the counterfactual framework was used to quantify the mediating role of the TyG index in the associations involving BD intensity, obesity, their interaction, and liver enzyme abnormalities.ResultsThe interaction between obesity and high-intensity binge drinking (HIBD) was significantly associated with liver enzyme abnormalities (OR, 1.591; 95% CI, 1.401–1.806). IR, measured by the TyG index, statistically accounted for 36.6% (OR, 1.034; 95% CI, 1.029–1.039) of this association, exceeding the proportion explained in the HIBD alone (25.9%) or obesity alone (16.7%) pathways. No significant mediating effect of IR was observed for non-BD or low-intensity BD, regardless of obesity status.ConclusionThe TyG index serves as a critical mediator in the synergistic effects of HIBD and obesity on liver enzyme abnormalities. Targeting IR and reducing the intensity of alcohol consumption may help mitigate liver injury in young and middle-aged adults with obesity.https://www.frontiersin.org/articles/10.3389/fnut.2025.1554392/fullinsulin resistanceobesitybinge drinkingliver enzymesmetabolic dysfunctionyoung and middle-aged |
| spellingShingle | Jiayi Zhu Jiayi Zhu Jiayi Zhu Yinglong Duan Ying Li Yi Zhou Zitong Lu Nandan Chen Juan Luo Xingxing Wang Xiaoqian Dong Andy S. K. Cheng Yuan Liu Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study Frontiers in Nutrition insulin resistance obesity binge drinking liver enzymes metabolic dysfunction young and middle-aged |
| title | Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study |
| title_full | Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study |
| title_fullStr | Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study |
| title_full_unstemmed | Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study |
| title_short | Insulin resistance as a mediator of the association between obesity, high-intensity binge drinking, and liver enzyme abnormalities in young and middle-aged adults: a cross-sectional study |
| title_sort | insulin resistance as a mediator of the association between obesity high intensity binge drinking and liver enzyme abnormalities in young and middle aged adults a cross sectional study |
| topic | insulin resistance obesity binge drinking liver enzymes metabolic dysfunction young and middle-aged |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1554392/full |
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