INS and Hepatic fibrosis: Moreover, with regard to the metabolic risk factors considered in the MAFLD definition (1), participants with higher stages of liver fibrosis had significantly higher prevalence of prediabetes based on OGTT and/or HbA1c (p for trend = 0.01), and were more insulin resistant as indicated by HOMA-IR ≥2.5 (p for trend <0.001).