Insulin Resistance and Nonalcoholic Fatty Liver Disease in Non-obese Hypertensive Patients

Objective To investigate the relationship between insulin resistance and nonalcoholic fatty liver disease (NAFLD) in non-obese hypertensive patients. Methods Ninety-three non-obese, non-diabetic hypertensive patients were grouped as hypertensive patients with NAFLD(n=45) and hypertensive patients without NAFLD(n=48) diagnosed ultrasonography. Body mass index(BMI), blood pressure, fast and OGGT 2 hour plasma glucose, fast and OGGT 2 hour plasma insulin, plasma lipids and aminotransferase were measured. Insulin resistance(IR) was estimated from plasma insulin and glucose as the homeostasis model assessment(HOMA) index. Multivariate logistic regression analysis was used to identify the variables associated with NAFLD. Result The group with NAFLD had significantly higher BMI(25.2±1.5 vs 24.1±1.9, P=0.002), triglycerides(2.3±1.0 vs 1.9±0.8, P=0.034), fast insulin (15.0±6.0 vs 10.9±5.3, P=0.001), OGGT 2 hour insulin(50.5±22.4 vs 37.9±16.0, P=0.003) alanine aminotransferase(ALT)(22.8±8.9 vs 16.7±6.7, P0.001), aspartate aminotransferase(AST)(18.8±6.4 vs 16.2±5.1, P=0.030)and HOMA-IR(1.2±0.5 vs 0.8±0.5, P=0.001)than the group without NAFLD. Multivariate logistic regression analysis (forward LR) showed HOMA-IR(OR 2.847, 95% CI 1.122-7.228; P=0.028)and ALT(OR 1.075, 95% CI 1.013-1.140;P=0.016)were independently associated with NAFLD. Conclusion Hypertensive patients with NAFLD have significantly higher insulin resistance than those without NAFLD. Insulin resistance is an independent risk factor for NAFLD in non-obese hypertensive patients.