Metabolic correlates of nonalcoholic fatty liver in women... : Hepatology (original) (raw)
Steatohepatitis/Metabolic Liver Disease
Vega, Gloria Lena1,2,3,4*; Chandalia, Manisha1,2,3; Szczepaniak, Lidia S.2,3; Grundy, Scott M.1,2,3,4*
1 The Center for Human Nutrition of the University of Texas Southwestern Medical Center at Dallas, Texas
2 Donald W. Reynolds Cardiovascular Research Center of the University of Texas Southwestern Medical Center at Dallas, Texas
3 Departments of Clinical Nutrition and Internal Medicine of the University of Texas Southwestern Medical Center at Dallas, Texas
4 The Veterans Affairs Medical Center, Dallas, TX
* University of Texas Southwestern Medical Center, Center for Human Nutrition, 5323 Harry Hines Boulevard, Dallas, TX 75390-9052
Email:[email protected]
Email:[email protected]
Received 26 January 2007; Accepted 12 March 2007
Published online in Wiley InterScience (www.interscience.wiley.com).
Grant sponsor: Donald W. Reynolds Foundation; Grant sponsor: The Moss Heart Foundation; Grant sponsor: Veterans Affairs Merit grant; Grant sponsor: General Clinical Research Center grant; Grant Number: GCRC USPHS grant M01-RR00633.
Potential conflict of interest: Nothing to report.
fax: 214-648-4837
Abstract
Nonalcoholic hepatic steatosis associates with a clustering of metabolic risk factors and steatohepatitis. One risk factor for hepatic steatosis is obesity, but other factors likely play a role. We examined metabolic concomitants of hepatic steatosis in nonobese and obese men and women. Sixty-one obese women and 35 obese men were studied; both those with and without hepatic steatosis were compared against each other and against nonobese controls (17 women and 32 men) without hepatic steatosis. Obesity (defined as ≥25% body fat in men and ≥35% in women), was identified by x-ray absorptiometry, whereas hepatic steatosis (≥5.5% liver fat) was detected by magnetic resonance spectroscopy. The primary endpoint was a difference in insulin sensitivity. Obese groups with and without steatosis had similar body fat percentages. Compared with obese women without hepatic steatosis, those with steatosis were more insulin resistant; the same was true for men, although differences were less striking. Obese subjects with hepatic steatosis had higher ratios of truncal-to-lower body fat and other indicators of adipose tissue dysfunction compared with obese subjects without steatosis. Conclusion : These results support the concept that obesity predisposes to hepatic steatosis; but in addition, insulin resistance beyond that induced by obesity alone and a relatively high ratio of truncal-to-lower body fat usually combined with obesity to produce an elevated liver fat content. (Hepatology 2007.)
Abbreviations: AUC, area under the curve; CRP, C-reactive protein; DHS, Dallas Heart Study; DXA, dual x-ray absorptiometry; HTGC, hepatic triglyceride content; MRS, magnetic resonance spectroscopy; NEFA, nonesterified fatty acids; OGIS, oral glucose insulin sensitivity index; OGTT, oral glucose tolerance test.
Copyright © 2007 American Association for the Study of Liver Diseases.