Metabolic Syndrome, Insulin Resistance, And Liver Pathologies: Contemporary Morphofunctional Perspectives

Background: Metabolic syndrome (MetS) is a complex clinical condition characterized by central obesity, insulin resistance, dyslipidemia, hypertension, and impaired glucose tolerance. Among its systemic consequences, the interplay between insulin resistance and liver pathology is of critical importance due to the rising prevalence of non-alcoholic fatty liver disease (NAFLD) and related metabolic disturbances.

Objective: To analyze modern morphofunctional perspectives on insulin resistance and liver pathologies in the context of metabolic syndrome, focusing on pathogenetic mechanisms, diagnostic approaches, and clinical implications.

Methods: A narrative literature review of peer-reviewed studies published between 2015–2025 was conducted using PubMed, Scopus, and Web of Science databases. Studies examining the relationship between metabolic syndrome, insulin resistance, and hepatic morphofunctional changes were included.

Results: Evidence highlights the central role of insulin resistance in the development of hepatic steatosis, hepatocellular injury, and fibrosis. Morphological findings in the liver include steatosis, lobular inflammation, hepatocyte ballooning, and progressive fibrotic changes. Functional impairments involve altered glucose homeostasis, dysregulated lipid metabolism, and hepatic insulin signaling defects. Molecular pathways, including the PI3K/Akt signaling cascade, mitochondrial dysfunction, and chronic low-grade inflammation, were found to be key contributors.

Conclusion: Insulin resistance in metabolic syndrome drives profound morphofunctional alterations in the liver, serving as a precursor to NAFLD and its progressive forms. Recognition of these mechanisms offers opportunities for early diagnosis, targeted therapy, and prevention strategies aimed at reducing the global burden of metabolic and hepatic diseases.