Metabolic and histological implications of intrahepatic triglyceride content in nonalcoholic fatty liver disease

Abstract

IHTG accumulation is strongly associated with adipose tissue insulin resistance (IR), supporting the current theory of lipotoxicity as a driver of IHTG accumulation. Once IHTG accumulation reaches ∼6 ± 2%, skeletal muscle IR, hypertriglyceridemia, and low HDL-C become fully established. Histological activity appears to have an early threshold and is not significantly influenced by increasing amounts of IHTG accumulation. (Hepatology 2017;65:1132-1144).

Twenty‐five‐year trajectories of insulin resistance and pancreatic β‐cell response and diabetes risk in nonalcoholic fatty liver disease

“…However, the liver is also the primary site of insulin clearance in humans . Several studies have shown that HOMA‐IR elevation in NAFLD is primarily related to impaired hepatic insulin clearance rather than impaired insulin suppression of hepatic glucose production . Thus, HOMA‐IR may be a poor overall marker of hepatic IR in NAFLD and the relationship between glucose and insulin is impaired in these patients.…”

Liver fat accumulation as a barometer of insulin responsiveness again points to adipose tissue as the culprit

“…The data provided by Bril et al from a well‐characterized cohort of adults with the full spectrum of NAFLD demonstrates that impairment of insulin responsiveness in the liver (measured by insulin‐mediated suppression of endogenous glucose production), muscle (measured by insulin‐stimulated glucose uptake), and adipose tissue (measure by insulin‐mediated suppression of lipolysis) was markedly different in these three major targets of insulin signaling. One interpretation of their data is that there is an underlying metabolic defect responsible for these changes.…”

Неінвазивна Діагностика Фіброзу Печінки У Хворих Із неалкогольною Жировою Хворобою Печінки

“…Порівняно з УЗД сканування КТ та МРТ є кращими за наявності вогнищевого відкладення жиру [17], в інших випадках УЗД є більш чутливим у діагностиці НАЖХП [17,20]. Багатообіцяючим методом вважається магніт-но-резонансна спектроскопія (MRS), що виміряє вміст протонної фракції жиру та рівень тригліцеридів (ТГ) у печінці, починаючи з 5 %, але цей метод використо-вується більше в рамках наукових досліджень [21,22].…”