The influence of fatty liver on insulin clearance and insulin resistance in non-diabetic Japanese subjects.
OBJECTIVE
To determine whether fatty liver impairs insulin clearance and contributes to insulin resistance in obese and lean healthy non-diabetic men and women.


METHODS
Cross-sectional, descriptive.


METHODS
Medical outpatient clinic; university hospital.


METHODS
Twenty-seven (14 men) non-diabetic obese (Body fat % = 31.5 +/- 9.3; mean +/- s.d.) and 19 (13 men) non-diabetic non-obese (body fat % = 19.0 +/- 6.8; P < 0.01 vs obese) healthy subjects aged 31-64 without liver disease.


METHODS
Liver density relative to the spleen on CT scan (LFS), glucose infusion rate (GIR) and metabolic insulin clearance rate (MIC) during euglycemic hyperinsulinemic clamp; anthropometric (waist-hip ratio: WHR) and CT-determined (visceral fat area: VFA) measures of fat distribution.


RESULTS
Fatty liver was inversely related to MIC (r = -0.39; P < 0.01) with a positive correlation with fasting p-insulin (r = 0.39; P < 0.01). There were no statistically significant correlations between BMI, body fat % or WHR and MIC. GIR was inversely related to body fat % (r = -0.49; P < 0.01), VFA (r = -0.56; P < 0.01) and WHR (r = -0.36; P < 0.01) in all subjects, with an inverse relationship to fatty liver in men (r = -0.43; P < 0.05).


CONCLUSIONS
Increased steatosis of the liver is associated with reduced insulin clearance, contributing to insulin resistance in non-diabetic Japanese men and women.
Goto
T
T
Third Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Onuma
T
T
Takebe
K
K
Kral
J G
JG
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003430:Cross-Sectional Studies; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005234:Fatty Liver / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000378:metabolism / Q000493:pharmacokinetics* / Q000502:physiology; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014280:Triglycerides