Insulin Resistance, the Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease

Angelico, Francesco; Ben, Maria Del; Conti, Rita; Francioso, S.; Feole, K.; Fiorello, S.; Cavallo, Maria Gisella; Zalunardo, Beniamino; Lirussi, Flavio; Alessandri, C.; Violi, Francesco

doi:10.1210/jc.2004-1024

Cited by 261 publications

(178 citation statements)

References 25 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of diabetes mellitus in Iran is shockingly high, especially in young population [18] ; and it would not be hyperbolic to proclaim that diabetes mellitus is the mother of morbidity of all vital organs. Thus, for investigating organ damages induced by different diseases, independently, we have to censor the impact of diabetes mellitus in our patient population by excluding them from the study.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of NAFLD is not clearly defined, but there is a strong evidence in the literature that insulin resistance and visceral adiposity play major roles [18][19][20] . In our study, the prevalence of metabolic syndrome in patients with NAFLD was 26.4%, which is higher than that in the US general population (23.7%) [21] but is surprisingly lower than that reported in Iranian general population which was reported to be as high as 30%-31% [22,23] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Ghamar-Chehreh

Amini

Khedmat

et al. 2012

Asian Pacific Journal of Tropical Biomedicine

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Ghamar-Chehreh

Amini

Khedmat

et al. 2012

Asian Pacific Journal of Tropical Biomedicine

View full text Add to dashboard Cite

“…An Italian study of 46 adults with NAFLD showed insulin resistance to be the strongest predictor of NAFLD, with fasting insulin levels nearly twice as high in patients with NAFLD as in controls. [26,15] NAFLD is also associated with an elevated serum triglycerides [27,28], low HDL-C [27], abnormal glucose regulation [29], and central adiposity [27], all features of the metabolic syndrome. A study of 30 non-obese adults with NAFLD and normal glucose tolerance showed these subjects to have significant insulin resistance and features of the MS, again implicating insulin resistance, even without obesity.…”

Section: Discussionmentioning

confidence: 99%

Presence of the Metabolic Syndrome in Obese Adolescents Predicts Impaired Glucose Tolerance and Nonalcoholic Fatty Liver Disease

Love-Osborne

Nadeau²,

Sheeder

et al. 2008

Journal of Adolescent Health

View full text Add to dashboard Cite

Purpose-To evaluate whether the presence of MS in obese adolescents is associated with other co-morbidities of obesity Methods-85 obese teens with fasting insulin > 25 uU/ml and family history of type 2 diabetes mellitus and/or acanthosis nigricans. Mean age 15.8 ± 1.7 years; body mass index 39.3 ± 6.6 kg/m2; 70% female; 54% Hispanic, 35% black. Laboratory analysis included fasting lipids, glucose, gamma gluteryl transferase (GGT), and oral glucose tolerance testing. Additional liver transaminases and liver ultrasound (US) were performed to evaluate presence and severity of fatty liver.Results-All subjects met MS criteria for children for waist circumference; 49% for blood pressure; 54% for high density lipoprotein (HDL); 54% for triglycerides; 20% for impaired fasting glucose or impaired glucose tolerance (IGT). 47 subjects had 3 or more MS criteria. BMI was no different between groups with and without MS. Subjects with 3 or more MS criteria were more likely to have IGT (p = .004), elevated ALT (p = .039), elevated GGT (p = .036), fatty liver on US (p < .001), and more severe fatty liver (p = .001).Reprint requests: kathryn.love-osborne@dhha.org, University of Colorado at Denver and Health Sciences Center, Denver Health and Hospitals Authority Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Abnormal glucose regulation and evidence of non-alcoholic fatty liver disease (NAFLD) were more common in subjects meeting 3 criteria for MS than in those meeting fewer criteria. The identification of MS provides value to the primary care provider. Those patients meeting criteria for MS should be evaluated for glucose intolerance and NAFLD. NIH Public Access

show abstract

“…Many studies suggest that NAFLD often represents the hepatic component of the metabolic syndrome, which is characterized by obesity, hyperinsulinemia, peripheral insulin resistance, diabetes, and hypertension [3e6]. The reported prevalence of NAFLD in patients with diabetes is 40e80%, and it is frequently associated with obesity e mainly abdominal e hypertriglyceridemia, and high-normal levels of alanine aminotransferase (ALT) [7,8]. NAFLD has long been considered a benign disease, but recent studies show that in some cases it evolves into nonalcoholic steato-hepatitis (NASH) [9].…”

mentioning

confidence: 99%

Nonalcoholic fatty liver disease (NAFLD) in nonobese patients with diabetes: Prevalence and relationships with hemodynamic alterations detected with Doppler sonography

Gaiani

Avogaro

Bombonato

et al. 2009

Journal of Ultrasound

View full text Add to dashboard Cite

Aim: To evaluate the prevalence, severity, and hemodynamic features of nonalcoholic fatty liver disease (NAFLD) in nonobese diabetics. Methods: We studied 100 consecutive nonobese (body mass index [BMI] < 30) patients with type 1 (n Z 17) or type 2 (n Z 83) diabetes and no known causes of liver disease. Steatosis was diagnosed and graded with ultrasonography. Digital sonographic images of the liver and right kidney were analyzed with dedicated software (HDI-Lab), and the liver/kidney ratio of grey-scale intensity was calculated as an index of the severity of the steatosis. Severity scores ranging from 0 (none) to 5 (severe) were compared with sonographic and Doppler findings (right liver size, portal vein diameter and flow velocity, hepatic and splenic arterial pulsatility indices, hepatic-vein flow profile and A-and S-wave velocities). Results: The prevalence of steatosis was 24% in type I and 80% in type II diabetes (grade 1 in 17%, grade 2 in 34%, grade 3 in 33%, grade 4 in 9%, grade 5 in 7%). In patients with steatosis (especially those with grades 4e5 disease), hepatic volume was increased (p < 0.005). Portal vein diameter was increased in grade 5 steatosis. The hepatic artery pulsatility index was significantly increased, particularly in grades 4 and 5 (p < 0.0001); portal and A-wave velocities were significantly reduced in grades 3e5 (p < 0.001); and the hepatic vein flow profile was altered in 27% (biphasic: 20%, flat: 7%) patients with steatosis, although there was no correlation with severity. Conclusions: NAFLD is very frequent in nonobese diabetics with type 2 but not type 1 disease, and it is associated with hepatomegaly and liver hemodynamic alterations only when it is severe.

show abstract

Insulin Resistance, the Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease

Abstract: The findings stress the heterogeneous presentation of patients with the metabolic syndrome when the diagnosis is based on the broad Adult Treatment Panel III clinical criteria and demonstrate that those who are more insulin resistant have a higher prevalence of severe steatosis.

Cited by 261 publications

References 25 publications

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

Presence of the Metabolic Syndrome in Obese Adolescents Predicts Impaired Glucose Tolerance and Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) in nonobese patients with diabetes: Prevalence and relationships with hemodynamic alterations detected with Doppler sonography

Contact Info

Product

Resources

About