title: Influence of insulin resistance and adipokines in the grade of steatosis of nonalcoholic fatty liver disease.
abstract: The objective of this work was to study the influence of insulin resistance and adipokines on the grade of steatosis in patients with NAFLD (nonalcoholic fatty liver disease) diagnosed by liver biopsy. A sample of 24 NAFLD patients was analyzed in a cross-sectional study. All patients with a two-week weight-stabilization period before recruitment were enrolled. A liver biopsy was realized. Weight, basal glucose, insulin, insulin resistance (HOMA), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and adipokines blood levels were measured. A nutritional evaluation (dietary intake, indirect calorimetry, and bioimpedance) was performed. The mean age was 41.6 +/- 8.7 years and the mean body mass index (BMI) 29.4 +/- 4.7. Twelve patients had a low grade of steatosis (grade 1 of the Brunt classification) and 12 patients had a high grade of steatosis (grade 2 or 3). Only HOMA was higher in patients with a high grade of steatosis (1.4 +/- 0.5 vs. 2.8 +/- 1.7 units; P < 0.05). Anthropometric data and dietary intake were similar for both groups. Blood levels of adiponectin were higher in patients with a low grade of steatosis (37.7 +/- 22.5 vs. 24.2 +/- 33 ng mL(-1); P < 0.05). Blood levels of resistin were higher in patients with a high grade of steatosis (2.36 +/- 0.6 vs. 2.8 +/- 0.6 mg mL(-1); P < 0.05), without differences in TNF-alpha or leptin levels. In logistic regression analysis, the HOMA-IR remained in the model, with an odds ratio to develop high grade of steatosis of 7.8 (95% CI: 1.8-75) with each 1 unit of HOMA-IR adjusted by age, sex, BMI, and dietary intake. This study demonstrates that insulin resistance determined with the HOMA model is associated with a high grade of steatosis in patients with NAFLD.
authors.affiliation: Institute of Endocrinology of Nutrition Medicine School and Gastroenterology Dept H Clinico Universitario, University of Valladolid, Valladolid, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Aller
authors.forename: Daniel A
authors.initials: DA
authors.lastname: de Luis
authors.forename: Luis
authors.initials: L
authors.lastname: Fernandez
authors.forename: Fernando
authors.initials: F
authors.lastname: Calle
authors.forename: Benito
authors.initials: B
authors.lastname: Velayos
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Olcoz
authors.forename: Olatz
authors.initials: O
authors.lastname: Izaola
authors.forename: Manuel Gonzalez
authors.initials: MG
authors.lastname: Sagrado
authors.forename: Rosa
authors.initials: R
authors.lastname: Conde
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Gonzalez
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D001706:Biopsy; D001835:Body Weight; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood* / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D054392:Adipokines