Nonalcoholic fatty liver disease a feature of the metabolic syndrome
Giulio Marchesini,Mara Brizi,Giampaolo Bianchi,Sara Tomassetti,Elisabetta Bugianesi,Marco Lenzi,Arthur J. McCullough,S. Natale,Gabriele Forlani,Nazario Melchionda +9 more
TLDR
It is concluded that NAFLD, in the presence of normoglycemia and normal or moderately increased body weight, is characterized by clinical and laboratory data similar to those found in diabetes and obesity.Abstract:
Insulin sensitivity (euglycemic clamp, insulin infusion rate: 40 mU m(-2) min(-1)) was studied in 30 subjects with biopsy-proven nonalcoholic fatty liver disease (NAFLD), normal glucose tolerance, and a BMI <30 kg/m(2) Of those 30 subjects, 9 had pure fatty liver and 21 had evidence of steatohepatitis In addition, 10 patients with type 2 diabetes under good metabolic control and 10 healthy subjects were studied Most NAFLD patients had central fat accumulation, increased triglycerides and uric acid, and low HDL cholesterol, irrespective of BMI Glucose disposal during the clamp was reduced by nearly 50% in NAFLD patients, as well as in patients with normal body weight, to an extent similar to that of the type 2 diabetic patients Basal free fatty acids were increased, whereas insulin-mediated suppression of lipolysis was less effective (-69% in NAFLD vs -84% in control subjects; P = 0003) Postabsorptive hepatic glucose production (HGP), measured by [6,6-(2)H(2)]glucose, was normal In response to insulin infusion, HGP decreased by only 63% of basal in NAFLD vs 84% in control subjects (P = 0002) Compared with type 2 diabetic patients, NAFLD patients were characterized by lower basal HGP, but with similarly reduced insulin-mediated suppression of HGP There was laboratory evidence of iron overload in many NAFLD patients, but clinical, histological, and biochemical data (including insulin sensitivity) were not correlated with iron status Four subjects were heterozygous for mutation His63Asp of the HFE gene of familiar hemochromatosis We concluded that NAFLD, in the presence of normoglycemia and normal or moderately increased body weight, is characterized by clinical and laboratory data similar to those found in diabetes and obesity NAFLD may be considered an additional feature of the metabolic syndrome, with specific hepatic insulin resistanceread more
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Survival, liver failure, and hepatocellular carcinoma in obesity‐related cryptogenic cirrhosis
Vlad Ratziu,Luminita Bonyhay,Vincent Di Martino,Frédéric Charlotte,Lucas Cavallaro,Marie-Hélène Sayegh-Tainturier,Philippe Giral,André Grimaldi,Pierre Opolon,Thierry Poynard +9 more
TL;DR: It is concluded that obesity‐related cirrhosis should now be recognized as a distinct entity that can cause severe liver disease and death.
Journal ArticleDOI
Fat quantification with IDEAL gradient echo imaging: correction of bias from T(1) and noise.
TL;DR: Two approaches to reduce the effects of T1 are demonstrated: small flip angle (flip angle) and dual flip angle methods and two methods to reduce noise bias are shown to effectively minimize deviation of the measured fat‐fraction from its true value.
Journal ArticleDOI
From the metabolic syndrome to NAFLD or vice versa
Ester Vanni,Elisabetta Bugianesi,Anna Kotronen,Samuele De Minicis,Hannele Yki-Järvinen,Gianluca Svegliati-Baroni +5 more
TL;DR: Recently nuclear receptors have emerged as key regulators of lipid and carbohydrate metabolism for which specific pharmacological ligands are available, making them attractive therapeutic targets for NAFLD and NASH.
Journal ArticleDOI
Magnetic Resonance Elastography vs Transient Elastography in Detection of Fibrosis and Noninvasive Measurement of Steatosis in Patients with Biopsy-proven Nonalcoholic Fatty Liver Disease
Charlie C. Park,Phirum Nguyen,Carolyn Hernandez,Ricki Bettencourt,Kimberly Ramirez,Lynda Fortney,Jonathan Hooker,Ethan Z. Sy,Michael T. Savides,Mosab H. Alquiraish,Mark A. Valasek,Emily Rizo,Lisa Richards,David A. Brenner,Claude B. Sirlin,Rohit Loomba +15 more
TL;DR: In a prospective, cross-sectional study of more than 100 patients, MRE is found to be more accurate than TE in identification of liver fibrosis (stage 1 or more), using biopsy analysis as the standard and MRI-PDFF is more accurate in detecting all grades of steatosis in patients with NAFLD.
Journal ArticleDOI
Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life
Ingrid J. Hickman,J. R. Jonsson,Johannes B. Prins,Susan Ash,D. M. Purdie,Andrew D. Clouston,Elizabeth E. Powell +6 more
TL;DR: It is demonstrated that maintenance of weight loss and exercise in overweight patients with liver disease results in a sustained improvement in liver enzymes, serum insulin levels, and quality of life.
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