title: Insulin resistance, postprandial GLP-1 and adaptive immunity are the main predictors of NAFLD in a homogeneous population at high cardiovascular risk.
abstract: The role of the different factors associated with fatty liver is still poorly defined. We evaluated the relationships between liver fat content (LF) and metabolic, inflammatory and nutritional factors in a homogeneous cohort of individuals at high cardio-metabolic risk.
  
  
  
  In 70 individuals with high waist circumference and at least one more criterion for metabolic syndrome enrolled in a nutritional intervention study, LF was evaluated at baseline by hepatic/renal echo intensity ratio (H/R), together with dietary habits (7-day dietary record), insulin sensitivity and β-cell function (fasting and OGTT-derived indices), fasting and postprandial plasma GLP-1 and lipoproteins, and plasma inflammatory markers. H/R correlated positively with fasting and OGTT plasma glucose and insulin concentrations, HOMA-IR and β-cell function, and IL-4, IL-17, IFN-γ, TNF-α, FGF and GCSF plasma concentrations (p < 0.05 for all), and negatively with insulin sensitivity (OGIS), dietary, polyphenols and fiber (p < 0.05 for all). By multiple stepwise regression analysis, the best predictors of H/R were OGIS (β = -0.352 p = 0.001), postprandial GLP-1 (β = -0.344; p = 0.001), HDL-cholesterol (β = -0.323; p = 0.002) and IFN-γ (β = 0.205; p = 0.036).
  
  
  
  A comprehensive evaluation of factors associated with liver fat, in a homogeneous population at high cardio-metabolic risk, indicated a pathogenic combination of the same pathways underlying the atherosclerotic process, namely whole body insulin sensitivity and inflammation. The higher predictive value of postprandial variables suggests that liver fat is essentially a postprandial phenomenon, with a relevant role possibly played by GLP-1.
  
  
  
  NCT01154478.
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bozzetto
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Annuzzi
authors.affiliation: Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ragucci
authors.affiliation: Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Di Donato
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Della Pepa
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Della Corte
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Griffo
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Anniballi
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giacco
authors.affiliation: Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. Electronic address: rivelles@unina.it.
authors.forename: A A
authors.initials: AA
authors.lastname: Rivellese
mesh_terms: D056704:Adaptive Immunity; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D015930:Diet Records; D005247:Feeding Behavior; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007371:Interferon-gamma / Q000097:blood; D007558:Italy; D008099:Liver / Q000000981:diagnostic imaging / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000178:diet therapy / Q000209:etiology* / Q000276:immunology; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000178:diet therapy / Q000209:etiology* / Q000276:immunology; D009752:Nutritional Status; D019518:Postprandial Period; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; C573415:IFNG protein, human; D018836:Inflammation Mediators; D007328:Insulin; D007371:Interferon-gamma; D052216:Glucagon-Like Peptide 1
keywords: GLP-1; HDL; IFN-g; Inflammation; Insulin resistance; NAFLD