title: Insulin Resistance but Not Visceral Adiposity Index Is Associated with Liver Fibrosis in Nondiabetic Subjects with Nonalcoholic Fatty Liver Disease.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, type 2 diabetes mellitus, and dyslipidemia. It is well known that the presence of visceral fat increases the risk for metabolic complications of obesity, especially NAFLD. The visceral adiposity index (VAI), a novel marker of visceral fat dysfunction, shows a strong association with insulin resistance and also cardiovascular and cerebrovascular events. However, there is conflicting data regarding the association between VAI and NAFLD. Our aim was to assess the relationship between VAI, insulin resistance, adipocytokines, and liver histology, in nondiabetic subjects with NAFLD.
  
  
  METHODS
  A total of 215 male patients with biopsy-proven NAFLD were included. Among this group, serum levels of adiponectin, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) were measured in 101 patients whose blood samples were available.
  
  
  RESULTS
  High gamma-glutamyl transferase (GGT), high total cholesterol (TC), high triglycerides (TGs), low high-density lipoprotein cholesterol (HDL-C), and presence of metabolic syndrome were significantly associated with higher VAI, although only higher GGT and TC were independent factors on multiple linear regression analysis. On the other hand, no significant association was found between VAI and adiponectin, TNF-α, IL-6, and hsCRP levels. The multivariate analysis of variables in patients with (n=124) and without (n=91) fibrosis showed that only higher homeostasis model assessment of insulin resistance value was independently associated with liver fibrosis.
  
  
  CONCLUSIONS
  Our findings suggest that VAI is not related to the severity of hepatic inflammation or fibrosis in nondiabetic patients with NAFLD. The lack of association between the adipocytokines and VAI also implies that the VAI may not be a significant indictor of the adipocyte functions.
authors.affiliation: 1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
authors.forename: Cemal Nuri
authors.initials: CN
authors.lastname: Ercin
authors.affiliation: 1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
authors.forename: Teoman
authors.initials: T
authors.lastname: Dogru
authors.affiliation: 2 İzmir Military Hospital 2, İzmir, Turkey .
authors.forename: Halil
authors.initials: H
authors.lastname: Genc
authors.affiliation: 1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
authors.forename: Gurkan
authors.initials: G
authors.lastname: Celebi
authors.affiliation: 3 Department of Gastroenterology, Katip Celebi University , İzmir, Turkey .
authors.forename: Fatih
authors.initials: F
authors.lastname: Aslan
authors.affiliation: 1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
authors.forename: Hasan
authors.initials: H
authors.lastname: Gurel
authors.affiliation: 4 Department of Gastroenterology, Haydarpasa Training Hospital , İstanbul, Turkey .
authors.forename: Muammer
authors.initials: M
authors.lastname: Kara
authors.affiliation: 5 Medical Biochemistry , Anittepe Military Dispensary, Ankara, Turkey .
authors.forename: Erdim
authors.initials: E
authors.lastname: Sertoglu
authors.affiliation: 6 Medical Biochemistry , Gulhane School of Medicine, Ankara, Turkey .
authors.forename: Serkan
authors.initials: S
authors.lastname: Tapan
authors.affiliation: 1 Gulhane School of Medicine , Department of Gastroenterology, Ankara, Turkey .
authors.forename: Sait
authors.initials: S
authors.lastname: Bagci
authors.affiliation: 7 Department of Clinical Medicine and Emerging Diseases, Palermo University , Palermo, Italy .
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: 8 Department of Endocrinology, Gulhane School of Medicine , Ankara, Turkey .
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein