Distinguishing nonalcoholic steatohepatitis from fatty liver: serum‐free fatty acids, insulin resistance, and serum lipoproteins

Liver International - Tập 26 Số 5 - Trang 566-571 - 2006
Ian Bookman1, Jonathan Pham2, Maha Guindi3, E. Jenny Heathcote2
1Department of Medicine, University of Toronto, Toronto, Canada
2Departments of Medicine
3Pathology, University Health Network, University of Toronto, Toronto, Canada

Tóm tắt

Abstract: Objectives: The prognosis of nonalcoholic fatty liver disease is determined by liver biopsy; steatohepatitis can be progressive whereas fatty liver is benign. Insulin resistance and increased hepatic‐free fatty acids are central to the pathophysiology of this disorder. Our objective was to assess whether serum‐free fatty acids, lipoproteins, and insulin resistance are increased in steatohepatitis compared with fatty liver and healthy controls, and thus may be potential noninvasive markers for liver disease severity.Methods: Fifteen subjects with biopsy proven nonalcoholic steatohepatitis, 15 with histological fatty liver, and 15 healthy controls were enrolled. Fasting serum glucose and insulin levels, serum‐free fatty acids, HDL, LDL, and cholesterol were collected from each subject. Insulin resistance was calculated using the homeostasis assessment model.Results: Insulin resistance, LDL, and cholesterol‐to‐HDL ratio values were significantly higher in steatohepatitis, whereas HDL was significantly lower compared with both fatty liver and controls. Free fatty acids were similar in all groups.Conclusions: Along with insulin resistance, serum LDL, and cholesterol‐to‐HDL ratio values increase with worsening severity of liver histology, and serum HDL values decline. Free fatty acids, however, do not vary between groups.

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Tài liệu tham khảo

10.7326/0003-4819-126-2-199701150-00008

James O F, 1998, Non‐alcoholic steatohepatitis (NASH), a disease of emerging identity and importance, 29, 495

Powell E E, 1990, The natural history of nonalcoholic steatohepatitis, a follow up study of forty-two subjects for up to 21 years, 11, 74

Day C P, 1998, Steatohepatitis, a tale of two ‘hits’?, 114, 842

Luyckx F H, 2000, Non‐alcoholic steatohepatitis: association with obesity and insulin resistance, and influence of weight loss, Diabetes Metab, 26, 98

Cortez‐Pinto H, 1999, Non‐alcoholic fatty liver, another feature of the metabolic syndrome?, 18, 353

Campbell P J, 1994, Fat metabolism in human obesity, Am J Physiol, 266, E600

10.1016/S1388-1981(99)00182-1

10.1042/bj2840457

Gibbons G F, 1995, Intracellular triacylglycerol lipase, its role in the assembly of hepatic very-low density lipoprotein (VLDL), 35, 179

Sanyal A J, 2001, Nonalcoholic steatohepatitis, association of insulin resistance and mitochondrial abnormalities, 120, 1183

10.1016/S0002-9343(99)00271-5

Goto T, 1995, The influence of fatty liver on insulin clearance and insulin resistance in non‐diabetic Japanese subjects, Int J Obes Relat Metab Disord, 19, 841

Lee J H, 1986, Role of hyperinsulinemia and glucose intolerance in the pathogenesis of nonalcoholic fatty liver in subjects with normal body weight, Gastroenterology, 24, 403

Chitturi S, 2002, NASH and insulin resistance, insulin hypersecretion and specific association with the insulin resistance syndrome, 35, 373

10.1053/jhep.2003.50161

10.1002/hep.20023

Hui J M, 2004, Beyond insulin resistance in NASH, TNF-α or Adiponectin?, 40, 46

10.1067/S0022-3476(03)00325-1

Dixon J B, 2001, Nonalcoholic fatty liver disease, predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese, 121, 91

Yngve F‐Y, 2001, Clinical features and natural history of nonalcoholic steatosis syndromes, Sem Liver Disease, 21, 17, 10.1055/s-2001-12926

Younossi Z M, 1998, Nonalcoholic fatty liver disease, assessment of variability in pathologic interpretations, 11, 560

Brunt E M, 1999, Nonalcoholic steatohepatitis, a proposal for grading and staging histological lesions, 94, 2467

10.2337/diacare.21.12.2191

Bonora E, 2000, Homeostasis model assessment mirrors the glucose clamp technique in the assessment of sensitivity, studies in subjects with various degrees of glucose tolerance and insulin sensitivity, 23, 57

Plan and operation of the Third National Health and Nutrition Examination Survey 1988–1994.National Center for Health Statistics. Vital Health Statistics. Series 1 No.32 1994

10.1056/NEJMoa033179

Kinosian B, 1994, Cholesterol and coronary heart disease, predicting risks by levels and ratios, 121, 641

10.1152/ajpendo.00117.2003

10.2337/diacare.27.1.33

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Liver International

Tập 26 Số 5

566-571

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