Investigation of hepatic gluconeogenesis pathway in non-diabetic Asian Indians with non-alcoholic fatty liver disease using in vivo ((31)P) phosphorus magnetic resonance spectroscopy.
OBJECTIVE
To study hepatic gluconeogenesis pathway in non-diabetic Asian Indian males having non-alcoholic fatty liver disease (NAFLD) using in vivo ((31)P) phosphorous magnetic resonance spectroscopy (MRS) and correlate these data with anthropometry and insulin resistance.


METHODS
Forty non-diabetic patients with NAFLD and 20 healthy controls were divided into (i) obese with NAFLD (group I, n=20), (ii) non-obese with NAFLD (group II, n=20) and (iii) non-obese without NAFLD (group III, n=20). Anthropometric and biochemical profiles, short insulin tolerance test (SITT), liver ultrasound, and (31)P MRS (to determine hepatic gluconeogenesis metabolite; phosphomonoesters (PMEs), inorganic phosphate (Pi) and their ratios with respect to ATP) were done.


RESULTS
Insulin resistance (Kitt value) was highest in group I (p<0.05; compared to other two groups), but was also higher in group II as compared to group III (p=ns). The values of PME/Pi, PME/gammaATP, PME/betaATP, PME/tATP ratios were higher (p<0.05) in group I compared to other two groups. Interestingly, non-obese subjects with NAFLD also showed more derangements of hepatic gluconeogenesis metabolites than non-obese subjects without NAFLD. Positive correlation was observed between PME and other ratios in relation to body mass index, waist circumference, body fat percentage and fasting serum insulin levels in all the three groups.


CONCLUSIONS
Derangements in hepatic gluconeogenesis as assessed non-invasively using (31)P MRS, was observed in obese and non-obese, non-diabetic Asian Indians with NAFLD. Further research is warranted whether this investigation in NAFLD subjects could be developed as a non-invasive tool to assess those predisposed to develop hyperglycemia.
Sharma
Rajeev
R
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India.
Sinha
Sanjeev
S
Danishad
K A
KA
Vikram
Naval K
NK
Gupta
Arun
A
Ahuja
Vineet
V
Jagannathan
N R
NR
Pandey
R M
RM
Misra
Anoop
A
D000328:Adult; D000886:Anthropometry; D044466:Asian People; D016022:Case-Control Studies; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis*; D005943:Gluconeogenesis; D005951:Glucose Tolerance Test; D006801:Humans; D007194:India; D007333:Insulin Resistance; D008099:Liver / Q000000981:diagnostic imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010759:Phosphorus Isotopes; D014463:Ultrasonography
D010759:Phosphorus Isotopes