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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Effect of leptin replacement on intrahepatic and intramyocellular lipid content in patients with generalized lipodystrophy
TL;DR: Reduction in IMCL and intrahepatic lipid content may partly explain leptin-induced improvement in insulin sensitivity in patients with generalized lipodystrophy.
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Effect of endurance exercise on hepatic lipid content, enzymes, and adiposity in men and women.
TL;DR: There was a strong relationship between GGT/ALT and body composition (percent BF) as well as between ALT and hepatic lipid content and short‐term endurance training without weight loss does not alter hepatic cholesterol content.
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Hepatocellular carcinoma in nonalcoholic fatty liver: Role of environmental and genetic factors
TL;DR: A deeper understanding of the mechanisms mediating hepatic carcinogenesis during insulin resistance, and the identification of its genetic determinants will hopefully provide new diagnostic and therapeutic tools.
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Circulating Levels and Hepatic Expression of Molecular Mediators of Atherosclerosis in Nonalcoholic Fatty Liver Disease
Silvia Cristina Sookoian,Gustavo Osvaldo Castaño,Adriana Laura Burgueño,Maria Soledad Rosselli,Tomás Fernández Gianotti,Pablo Mallardi,Julio San Martino,Carlos José Pirola +7 more
TL;DR: NAFLD is associated with elevated circulating levels and abnormal liver expression of molecular mediators of atherosclerosis and ICAM-1 may be involved in liver damage and inflammation; a significant correlation was found between both the degree of liver steatosis and the severity of necroinflammatory activity and liver ICam-1 expression.
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Clinical trial: insulin‐sensitizing agents may reduce consequences of insulin resistance in individuals with non‐alcoholic steatohepatitis
Ramazan Idilman,D. Mizrak,D. Corapcioglu,Mehmet Bektas,Beyza Doganay,M. Sayki,Sahin Coban,Esra Erden,Irfan Soykan,R. Emral,Ali Riza Uysal,Ali Özden +11 more
TL;DR: This work has shown that once the liver test abnormalities with/without improving the liver histology are normal, the treatment of non‐alcoholic steatohepatitis can be improved through pharmacologic therapy.
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