Association of Nonalcoholic Fatty Liver Disease With Insulin Resistance

Abstract

Nonalcoholic fatty liver disease (NAFLD) is frequently associated with type 2 diabetes mellitus, obesity, and dyslipidemia. We tested the hypothesis that there may be an association between NAFLD and insulin resistance (IR); and its correlation with glucose tolerance status of subjects who aren't known patients with diabetes. One hundred and seventy-six consecutive patients with elevated serum aminotransferase levels and bright liver were evaluated. Sixty-two patients were excluded from the study. Age, gender, height, weight, body mass index, waist circumferences, and family history of diabetes were recorded. Fasting plasma glucose, insulin, lipid profile were measured. A standard oral glucose tolerance test (OGTT) was performed and the index of IR was calculated according to the HOMA method. Patients with a normal glucose tolerance formed group 1 (64 patients) and patients with impaired or diabetic glucose tolerance group 2 (50 patients). Age, female sex, family history of type 2 diabetes, fasting insulin, fasting plasma glucose and HOMA-R index were statistically significantly different between the groups. Although the subjects in the study are not known patients with diabetes, the prevalence of impaired or diabetic glucose tolerance was prominent. In conclusion, performing OGTT in cases with nonalcoholic fatty liver disease may be useful for early screening of diabetes mellitus.

Mesenteric fat thickness as an independent determinant of fatty liver

“…The role of gender in fatty liver is still controversial as male or female preponderance of fatty liver was shown in different studies. [43][44][45] In this study, fatty liver is more prevalent in men than in women, and this might be because men were more obese than women subjects in this study. Gender difference was demonstrated between subjects with fatty and nonfatty liver.…”

The Clinical Biochemistry of Obesity—More Than Skin Deep

“…46 Performing oral glucose tolerance testing in cases with fatty liver disease may be useful for early screening of diabetes mellitus. 47 Laboratory reference intervals for ALT may include variations due to BMI 48 as body weight explains 12% of the normal variation of ALT. 49 Laboratories should determine appropriate gender adjusted reference intervals for liver enzymes 50 and also take measures to exclude the presence of insulin resistance in their reference populations.…”

Nonalcoholic fatty liver is a risk factor for postprandial hyperglycemia, but not for impaired fasting glucose

“…A pathogenetic mechanism proposed for NASH is the ''twohit'' hypothesis, by which the accumulation of fat in hepatocytes contributes to increased hepatic oxidative stress [4]. This increased hepatic oxidative stress may cause insulin resistance, leading to further accumulation of fat in hepatocytes, and vice versa [5,6].…”