Non-alcoholic fatty liver: another feature of the metabolic syndrome?
OBJECTIVE
Hepatic steatosis and nonalcoholic steatohepatitis (NASH) have been associated with obesity, non insulin-dependent diabetes mellitus and hyperlipidemia. The present study was designed in order to evaluate whether patients with steatosis/NASH presented common features with the metabolic syndrome.


METHODS
In 30 patients with nonalcoholic fatty liver the prevalence of hypertension and diabetes; the glucose/insulin profile, lipid profile, and serum leptin were evaluated and correlated with body composition and energy expenditure, assessed by bioimpedance spectroscopy and indirect calorimetry, respectively. Results were compared with a group of eight controls.


RESULTS
Obesity was present in 80% of patients, hypertension in 50% and non insulin dependent diabetes in 33%. Glucose metabolism was altered in 69%, with elevated insulin in 14 patients. Serum leptin, higher in women, was increased in patients: 33.9 +/- 38.9 vs 9.6 +/- 6.9 ng/ml, P< 0.05. There was a correlation between insulin and leptin, both of which correlated with body mass index, fat mass and percentage of body fat. Dyslipidaemia was found in 80% of patients: 45% presented low high density lipoproteins cholesterol, 58% high low density lipoproteins and 38% elevated very low density lipoproteins.


CONCLUSIONS
There is a strong association between nonalcoholic fatty liver and features of the metabolic syndrome, suggesting a simultaneous insulin resistance and decreased sensitivity to leptin.
Cortez-Pinto
H
H
Department of Medicine, University Hospital of Santa Maria, Lisbon, Portugal.
Camilo
M E
ME
Baptista
A
A
De Oliveira
A G
AG
De Moura
M C
MC
D000328:Adult; D001786:Blood Glucose; D001823:Body Composition; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004734:Energy Metabolism; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D013577:Syndrome
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin