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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Fasting insulin and uric acid levels but not indices of iron metabolism are independent predictors of non-alcoholic fatty liver disease. A case-control study.
Amedeo Lonardo,Paola Loria,F. Leonardi,A. Borsatti,P. Neri,Pulvirenti M,Am Verrone,A. Bagni,Marco Bertolotti,D. Ganazzi,Nicola Carulli +10 more
TL;DR: Fasting insulin and serum uric acid levels indicating insulin resistance, but not indices of iron overload, are independent predictors of non-alcoholic fatty liver disease.
Journal ArticleDOI
Signalling mechanisms linking hepatic glucose and lipid metabolism
TL;DR: Some of the key factors that are involved in both the regulation of glucose and lipid metabolism in the liver are discussed, which may provide targets for dietary or pharmacological interventions.
Journal ArticleDOI
High prevalence of metabolic complications in patients with non‐alcoholic fatty liver disease
TL;DR: A significant proportion of patients with both clinical and histological diagnosis of NAFLD develop metabolic problems soon after diagnosis, and these patients should be screened regularly for metabolic disorders.
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Ectopic fat accumulation: an important cause of insulin resistance in humans
TL;DR: This review focuses on data suggesting that ectopic fat accumulation in the liver and skeletal muscle in humans are critical determinants of insulin resistance and may also predispose to the development of type 2 diabetes.
Journal ArticleDOI
The Effectiveness of Liraglutide in Nonalcoholic Fatty Liver Disease Patients With Type 2 Diabetes Mellitus Compared to Sitagliptin and Pioglitazone
Takamasa Ohki,Akihiro Isogawa,Masahiko Iwamoto,Mitsuru Ohsugi,Haruhiko Yoshida,Nobuo Toda,Kazumi Tagawa,Masao Omata,Kazuhiko Koike +8 more
TL;DR: Administration of liraglutide improved T2DM but also improvement of liver inflammation, alteration of liver fibrosis, and reduction of body weight.
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