Comparative evaluation of whole body and hepatic insulin resistance using indices from oral glucose tolerance test in morbidly obese subjects with nonalcoholic Fatty liver disease.
Nonalcoholic Fatty Liver Disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is a marker of Insulin Resistance (IR). Euglycemic-hyperinsulinemic clamp is the gold standard for measuring whole body IR (hepatic + peripheral IR). However, it is an invasive and expensive procedure. Homeostasis Model Assessment Index for Insulin Sensitivity (HOMA-IS), Quantitative Insulin Sensitivity Check Index (QUICKI) for hepatic IR and Insulin Sensitivity Index (ISI(0,120)), and Whole Body Insulin Sensitivity Index (WBISI) for whole body IR are the indices calculated after Oral Glucose Tolerance Test (OGTT). We used these indices as noninvasive methods of IR (inverse of insulin sensitivity) estimation and compared hepatic/peripheral components of whole body IR in NAFLD. Methods. 113 morbidly obese, nondiabetic subjects who underwent gastric bypass surgery and intraoperative liver biopsy were included in the study. OGTT was performed preoperatively and the indices were calculated. Subjects were divided into closely matched groups as normal, fatty liver (FL) and Non-Alcoholic Steatohepatitis (NASH) based on histology. Results. Whole body IR was significantly higher in both FL and NASH groups (NAFLD) as compared to Normal, while hepatic IR was higher only in NASH from Normal. Conclusions. FL is a manifestation of peripheral IR but not hepatic IR.
Qureshi
Kamran
K
Department of Medicine, University of Illinois at Urbana, Champaign, IL 61801, USA.
Clements
Ronald H
RH
Saeed
Fahad
F
Abrams
Gary A
GA
J Clin Endocrinol Metab. 2003 Jun;88(6):2399-403
12788834
Hepatology. 2002 Feb;35(2):373-9
11826411
J Hepatol. 1998 Sep;29(3):495-501
9765002
Clin Chem Lab Med. 2006;44(7):817-23
16776626
Am J Gastroenterol. 2007 Feb;102(2):399-408
17311652
Scand J Clin Lab Invest. 1985 Dec;45(8):741-51
3909372
Diabetologia. 1996 Mar;39(3):298-305
8721775
Am J Gastroenterol. 1999 Sep;94(9):2467-74
10484010
Diabetologia. 1985 Jul;28(7):412-9
3899825
World J Gastroenterol. 2007 Jul 14;13(26):3540-53
17659704
Hypertens Res. 2002 Jul;25(4):529-36
12358137
Gut. 2005 Jul;54(7):1003-8
15951550
Hepatology. 2005 Jun;41(6):1313-21
15915461
Nutr Metab Cardiovasc Dis. 2004 Dec;14(6):366-72
15853121
Gut. 2007 Sep;56(9):1296-301
17392334
Diabetes. 1999 Sep;48(9):1801-6
10480611
Am J Physiol. 1979 Sep;237(3):E214-23
382871
Diabetologia. 1995 Jun;38(6):699-704
7672492
N Engl J Med. 1987 Aug 6;317(6):350-7
3299096
Diabetes Res Clin Pract. 2000 Mar;47(3):177-84
10741566
Hepatology. 2002 Dec;36(6):1349-54
12447858
Hepatology. 2003 Apr;37(4):917-23
12668987
Gastroenterology. 2005 Jun;128(7):1898-906
15940625
J Clin Endocrinol Metab. 1988 Mar;66(3):580-3
3350907
Am J Physiol Endocrinol Metab. 2006 Oct;291(4):E697-703
16684857
J Clin Endocrinol Metab. 2000 Jul;85(7):2402-10
10902785