title: Subclinical inflammation in relation to insulin resistance in prediabetic subjects with nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is a metabolic disease commonly associated with obesity, type 2 diabetes, and inflammation-all features of insulin resistant syndrome. However, very limited data are available regarding the association of subclinical inflammation and insulin resistance with NAFLD in a prediabetic state. We, therefore, conducted the study to assess this relationship among this population.
  
  
  METHODS
  We studied a cross-sectional analytical design of 140 [male/female, 77/63; age in years (ranges), 45 (25-68)] prediabetic subjects after confirming with 75 g oral glucose tolerance test. The diagnosis of NAFLD was made by ultrasonic examination of the liver and divided into groups of without NAFLD (n = 63) and NAFLD (n = 77). All individuals underwent anthropometric and clinical examinations. Among laboratory investigations, serum glucose was estimated by glucose oxidase method, serum lipid profile and liver enzymes were measured by the enzymatic colorimetric method and glycated hemoglobin was measured by high performance liquid chromatography technique. Serum insulin and high sensitivity C reactive protein (hsCRP) were measured by enzyme immunoassay technique. Insulin resistance (HOMA-IR) was calculated by homeostasis model assessment (HOMA).
  
  
  RESULTS
  There was significantly higher levels of hsCRP (2.82 ± 1.60 vs. 1.39 ± 0.66 mg/l, P < 0.001) and HOMA-IR (4.03 ± 1.39 vs. 1.98 ± 1.04, P < 0.001) in NAFLD subjects compared to their without NAFLD counterparts. hsCRP [odds ratio (OR) = 5.888, 95 % confidence interval (CI) 2.673-12.970, P < 0.001] and HOMA-IR (OR = 4.618, 95 % CI 2.657-8.024, P < 0.001) showed significant determinants of NAFLD after potential confounders of body mass index and triglyceride were adjusted.
  
  
  CONCLUSIONS
  Subclinical chronic inflammation and insulin resistance seem to be independent mediators of the association between NAFLD and prediabetes. The data also indicate that the inflammatory condition and insulin resistance are associated with each other and these, in turn, are affected by adiposity and dyslipidemia in prediabetic subjects.
authors.affiliation: Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
authors.forename: Israt Ara
authors.initials: IA
authors.lastname: Hossain
authors.affiliation: Department of Biotechnology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
authors.forename: Salima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
authors.forename: Farjana Rahman
authors.initials: FR
authors.lastname: Bhuiyan
authors.affiliation: Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
authors.forename: Mijanur Rahman
authors.initials: MR
authors.lastname: Shah
authors.affiliation: Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh.
authors.forename: Mohammad Khalilur
authors.initials: MK
authors.lastname: Rahman
authors.affiliation: Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences, Dhaka, Bangladesh. vc@buhs-edu.org.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D011236:Prediabetic State / Q000150:complications / Q000503:physiopathology*