title: Relationship between glucose metabolism and non-alcoholic fatty liver disease severity in morbidly obese women.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is an independent predictor of type 2 diabetes mellitus (T2DM). Insulin resistance and beta-cell dysfunction are involved in the pathogenesis of T2DM. Insulin resistance is associated with NAFLD but little is known about beta-cell dysfunction and NAFLD.
  
  
  OBJECTIVE
  We tested whether NAFLD severity is associated with insulin sensitivity and beta-cell function in morbidly obese women.
  
  
  METHODS
  We studied 61 Caucasian women aged 18-60 years without T2DM and with a body mass index ranging from 35.3 to 48.8 kg/m². The insulin sensitivity index (ISI) and the disposition index (DI) from oral glucose tolerance testing were used as measures of insulin sensitivity and beta-cell function, respectively. Fat was measured by dual-energy X-ray absorptiometry. Fatty liver was diagnosed by ultrasonography and ordinally coded as 0 = none, 1 = light, 2 = moderate, 3 = severe. Proportional-odds logistic regression was used to evaluate the association of NAFLD severity with log(e)ISI and log(e)DI with and without correction for total and truncal fat.
  
  
  RESULTS
  The odds of more severe vs. less severe NAFLD decreased for increasing log(e)ISI [odds ratio (OR) 0.40, 95 % CI 0.19-0.84, p < 0.05] and log(e)DI (OR 0.80, 95 % CI 0.69-0.92, p < 0.01). Neither total nor truncal fat had any effect on these associations.
  
  
  CONCLUSIONS
  In morbidly obese women, NAFLD severity is inversely associated with insulin sensitivity and beta-cell function. The association of NAFLD severity with beta-cell dysfunction is stronger than that with insulin resistance.
authors.affiliation: Liver Research Center, AREA Science Park, Building Q, Strada Statale 14 km 163.5, Basovizza, 34012, Trieste, Italy. giorgiobedogni@gmail.com.|International Center for the Assessment of Nutritional Status (ICANS), University of Milano, Milan, Italy. giorgiobedogni@gmail.com.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bedogni
authors.affiliation: Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Gastaldelli
authors.affiliation: Liver Research Center, AREA Science Park, Building Q, Strada Statale 14 km 163.5, Basovizza, 34012, Trieste, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tiribelli
authors.affiliation: Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milano, Italy.
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Agosti
authors.affiliation: Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milano, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: De Col
authors.affiliation: Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases, Verbania, Italy.
authors.forename: Rezene
authors.initials: R
authors.lastname: Fessehatsion
authors.affiliation: Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milano, Italy.|Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases, Verbania, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sartorio
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging; D015502:Absorptiometry, Photon; D050154:Adiposity; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D007558:Italy; D008099:Liver / Q000000981:diagnostic imaging; D016015:Logistic Models; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D009767:Obesity, Morbid / Q000503:physiopathology*; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D007328:Insulin