Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients

Tj, Hsiao; Chen, JC; Wang, Jiaan-Der

doi:10.1038/sj.ijo.0802519

Cited by 96 publications

(79 citation statements)

References 36 publications

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“…In this study, insulin resistance was not a strong predictor of having fatty liver as observed in previous study, 28,29 which was controlled when body mass index was included in the regression model. This might be due to different ethnic groups or less obese subjects included in this study.…”

Section: Discussionmentioning

confidence: 57%

“…These findings were also in line with previous observation that fatty liver is associated with worse metabolic risk profile. [25][26][27][28][29] On multiple logistic regression, mesenteric fat thickness was the only abdominal fat deposit which showed significant association with fatty liver, independent of thickness of other abdominal fat deposits, body mass index, insulin resistance, lipid and blood pressure. These results are in line with the known metabolic properties of mesenteric fat which is directly drained by the portal vein (portal adipose tissue).…”

Section: Discussionmentioning

confidence: 98%

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Mesenteric fat thickness as an independent determinant of fatty liver

Liu

Chan

et al. 2006

Int J Obes

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Objective: Mesenteric fat is drained by the portal circulation and has been suggested to be a key component in obesity-related health risk, notably the metabolic syndrome. There are increasing epidemiological and experimental data showing that fatty liver is another component of this multifaceted syndrome. Given their intimate anatomical and physiological relationships, we hypothesized that mesenteric fat thickness may be independently associated with the risk of fatty liver. To test this hypothesis, we examined the predictive role of various fat deposits including mesenteric fat thickness, and various metabolic variables on the risk of fatty liver. Subjects and methods: A total of 291 Chinese subjects (134 men and 157 women with a mean BMI of 23.7 kg/m 2 , range: 16.5-33.4 kg/m 2 ) underwent ultrasound examination for measurement of mesenteric, subcutaneous and preperitoneal fat thickness, and for diagnosis of fatty liver. Body mass index, waist circumference, and waist-hip ratio were recorded. Blood pressure was measured. Fasting plasma glucose, insulin resistance, high-density lipoprotein cholesterol (HDL-C), triglycerides, low-density lipoprotein cholesterol (LDL-C), liver enzymes were determined by common methods. Results: The subjects with fatty liver had greater abdominal fat thickness and higher anthropometric indexes than those without fatty liver. The subjects with fatty liver also showed higher blood pressure, worse lipid and glycaemic profile compared with those without fatty liver. Using multiple logistic regression analysis, mesenteric fat thickness was a risk factor of fatty liver, independent of body mass index, age, sex, insulin resistance, fasting plasma glucose, lipid and blood pressure. The odds ratio was 1.5 (95% confidence interval: 1.27-1.77) for every 1 mm increase in the mesenteric fat thickness. Measurement of preperitoneal and subcutaneous fat deposits did not show significant associations with fatty liver. Conclusion: Mesenteric fat thickness measured on ultrasound is an independent determinant of fatty liver.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 98%

Mesenteric fat thickness as an independent determinant of fatty liver

Liu

Chan

et al. 2006

Int J Obes

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“…Serum transaminase concentrations are unreliable predictors of NAFLD, but an aspartate aminotransferase-to-alanine aminotransferase ratio Ͼ 1 has been associated with more advanced inflammation or fibrosis (61). Data also show an association between hyperferritinemia and more advanced NAFLD histology (58,(62)(63)(64).…”

Section: Liver Diseasementioning

confidence: 51%

“…Nonalcoholic fatty liver disease (NAFLD) is estimated to occur in 10% to 25% of the population worldwide (54). Both the development of NAFLD and its progression to the more severe histology of NASH are associated with obesity and type 2 diabetes (55)(56)(57)(58)(59). NASH is known to progress to cirrhosis in up to 25% of patients (60).…”

Section: Liver Diseasementioning

confidence: 99%

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

et al. 2005

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Criteria for patient selection and multidisciplinary evaluation and treatment of the weight loss surgery patient. Obes Res. 2005;13:234 -243. Objective: To provide evidence-based guidelines for patient selection and to recommend the medical and nutritional aspects of multidisciplinary care required to minimize perioperative and postoperative risks in patients with severe obesity who undergo weight loss surgery (WLS). Research Methods and Procedures: Members of the Multidisciplinary Care Task Group conducted searches of MEDLINE and PubMed for articles related to WLS in general and medical and nutritional care in particular. Pertinent abstracts and literature were reviewed for references. Multiple searches were carried out for various aspects of multidisciplinary care published between 1980 and 2004. A total of 3000 abstracts were identified; 242 were reviewed in detail. Results: We recommended multidisciplinary screening of WLS patients to ensure appropriate selection; preoperative assessment for cardiovascular, pulmonary, gastrointestinal, endocrine, and other obesity-related diseases associated with increased risk for complications or mortality; preoperative weight loss and cessation of smoking; perioperative prophylaxis for deep vein thrombosis and pulmonary embolism (PE); preoperative and postoperative education and counseling by a registered dietitian; and a well-defined postsurgical diet progression. Discussion: Obesity-related diseases are often undiagnosed before WLS, putting patients at increased risk for complications and/or early mortality. Multidisciplinary assessment and care to minimize short-and long-term risks include: comprehensive medical screening; appropriate pre-, peri-, and postoperative preparation; collaboration with multiple patient care disciplines (e.g., anesthesiology, pulmonary medicine, cardiology, and psychology); and long-term nutrition education/counseling.

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“…It is plausible that iron overload in the liver damages hepatocytes, which in turn would result in elevated transaminases and GGT. Although we did not have access to liver ultrasound or biopsy in our study, a correlation between ferritin level and non-alcoholic fatty liver disease or non-alcoholic steatohepatitis, which is associated with elevated ALT, has been described by others in both obese [28] and mainly non-obese [29] individuals. An association between raised hepatic iron concentration and severity of fibrosis in non-alcoholic steatohepatitis has also been reported [30].…”

Section: Discussionmentioning

confidence: 87%

Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study

et al. 2007

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Aims/hypothesis The aim of this study was to examine the association between baseline body iron stores and new-onset diabetes. Subjects and methods We studied the association between baseline serum ferritin concentration and type 2 diabetes in 360 clinically incident diabetes cases and 758 controls nested within the EPIC (European Prospective Investigation of Cancer)-Norfolk Cohort Study. Serum ferritin levels were categorised into five groups: sex-specific quartiles of the normal range of ferritin and a group with clinically raised ferritin below levels indicative of haemochromatosis. Results Baseline serum ferritin was higher among cases than control participants (geometric mean: men 96.6 vs 67.8 ng/ml, respectively, p<0.001; women 45.9 vs 34.8 ng/ ml, respectively, p=0.005). In analyses adjusted for known risk factors (age, BMI, sex, family history, physical activity, smoking habit) and dietary factors measured by 7-day food diary, the risk of diabetes was markedly elevated in participants with clinically raised ferritin compared with the lowest quartile (odds ratio [OR] 7.4, 95% CI 3.5-15.4). Further adjustment for potential confounding by inflammation (C-reactive protein, IL-6 and fibrinogen) had no material impact on the observed association, while adjustment for hepatic enzymes (alanine aminotransferase and γ glutamyl transferase) and adiponectin attenuated the magnitude of association, but it remained statistically significant (OR 3.2 [1.3-7.6]). Conclusions/interpretation Serum ferritin is an important and independent predictor of the development of diabetes. This finding may have important implications for understanding the aetiology of diabetes.

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Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients

Cited by 96 publications

References 36 publications

Mesenteric fat thickness as an independent determinant of fatty liver

Mesenteric fat thickness as an independent determinant of fatty liver

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study

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