Clinical StudiesAssociation of nonalcoholic fatty liver disease with insulin resistance
Section snippets
Patients
Since September 1997, all outpatients who visited our Department of Liver and Metabolic Disease for chronically elevated serum aminotransferase levels were screened for hepatitis B, C, and Epstein-Barr virus infection, nonorgan-specific autoantibodies, and hereditary defects (α1-antitrypsin deficiency and iron and copper storage diseases). Alcohol consumption was assessed by detailed history and laboratory markers (serum γ-glutamyl transpeptidase levels and mean corpuscular volume of red blood
Results
Among the 46 patients with nonalcoholic fatty liver disease (Table), 20 (43%) were overweight (body mass index from 25 to 30 kg/m2) and 13 were frankly obese (body mass index greater than 30 kg/m2). Of the 92 control subjects, 28 (30%) had a body mass index exceeding 25 kg/m2, but none was obese. Fat was mainly distributed in the splanchnic area. Among the patients, the mean waist circumference was 95 ± 14 cm in men and 87 ± 11 cm in women, significantly greater than in the controls [men 84 ±
Discussion
The present study demonstrates that insulin resistance, elevated serum triglyceride levels, hyperinsulinemia, and lower glucose levels after a glucose load are associated with nonalcoholic fatty liver disease, irrespective of body weight, body mass index, fat distribution, and glucose tolerance. The diagnosis of nonalcoholic fatty liver disease was based on exclusion of known etiologic factors responsible for liver disease (viral, genetic, autoimmune) and on ultrasound examinations, but was not
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