The relationship between insülin resistance, metabolic syndrome and nonalcoholic fatty liver disease in non-obese non-diabetic Turkish individuals: A pilot study

Abstract

Background/Aims: Nonalcoholic fatty liver disease is related to obesity, metabolic syndrome, and insulin resistance. Nonalcoholic fatty liver disease and metabolic syndrome may also be encountered in non-obese, non-diabetic individuals, and there are no published data about the prevalence of these conditions in non-obese, non-diabetic Turkish subjects. We aimed to determine the difference between non-obese, non-diabetic nonalcoholic fatty liver disease patients and healthy controls in terms of insulin resistance and metabolic syndrome in Turkish subjects. Materials and Methods: Non-obese, non-diabetic individuals (n=219) were enrolled. The cohort was divided into two groups according to presence of steatosis in ultrasonography: nonalcoholic fatty liver disease group (n=143) and healthy control group (n=76). Insulin resistance and metabolic syndrome were analyzed and compared between the two groups. Results: The prevalences of metabolic syndrome (32.2% vs. 5.3%, respectively; p<0.001) and insulin resistance (46.2% vs. 9.2%, respectively; p<0.001) were significantly higher in the nonalcoholic fatty liver disease group. According to multiple logistic regression analysis, age (odds ratio 1.534; p=0.0032), insulin resistance (odds ratio 1.074; p<0.001), and serum ALT levels (odds ratio 1.102; p<0.001) were independently associated with nonalcoholic fatty liver disease. Conclusion: Insulin resistance and metabolic syndrome are not rare in non-obese, non-diabetic Turkish subjects with nonalcoholic fatty liver disease. Ultrasonographically detected fatty liver was independently associated with insulin resistance, irrespective of the presence of metabolic syndrome.

Nonalcoholic fatty liver disease in lean subjects: Prognosis, outcomes and management

“…In accordance to the aforementioned studies, Oral et al[ 45 ] reported that non-obese (BMI < 30 kg/m 2 ) NAFLD patients from Turkey were more frequently glucose intolerant and had higher TG and TC levels than non-obese controls. Similar findings were also reported in another Turkish study, where lean (BMI < 25 kg/m 2 ) NAFLD patients had higher prevalence of hypertension and MetS as well as higher HOMA-IR[ 46 ]. Finally, in Europe, Feldman et al[ 47 ] reported that Austrian lean (BMI < 25 kg/m 2 ) healthy subjects were more frequently glucose tolerant and had lower prevalence of T2DM than lean NAFLD patients and these findings were confirmed by Gonzalez-Cantero et al[ 48 ] in a non-obese (BMI < 30 kg/m 2 ) Spanish cohort.…”

Angiopoietin-like protein 2 and angiopoietin-like protein 6 levels in patients with nonalcoholic fatty liver disease

“…The literature shows that serum ANGPTL2 and ANGPTL6 levels are increased in obese and diabetic patients [ 5 , 7 , 8 ]. Therefore, we included non-obese non-diabetic NAFLD patients in our study, and we found a significant difference in IR, HT, and MetS presence among the three groups; these findings were consistent with the findings reported in the literature [ 18 , 19 ].…”

Ultrasound/Elastography techniques, lipidomic and blood markers compared to Magnetic Resonance Imaging in non-alcoholic fatty liver disease adults

“…All results were statistically significant but, again the metabolomics, ultrasonography and combination panel showed the best predictions (ROC-AUC: 0.711; ROC-AUC: 0.746 and ROC-AUC: 0.773 respectively). The techniques that have major power of prediction were ultrasonography and OWLiver coinciding with those techniques that were more discriminative of metabolic factors as described previously 20, 54. Likewise, the combination of ALT, HOMA-IR and RBP-4 showed the best prediction with and accuracy of 77.3%.…”