The relevance of fatty liver and insulin resistance

Objective To investigate the disordered lipid metabolism, the degree of insulin resistance in patients with fatty liver and the relevance of fatty liver to insulin resistance. Methods The investigation was conducted by means of case control study. Anthropometrical parameters, serum lipids, fasting and 2 hour postprandial serum glucose, fasting and 2 hour postprandial serum insulin, free fatty acid(FFA) were measured in 67 patients of type 2 diabetes with fatty liver(DF), 33 type 2 diabetes mellitus without fatty liver(NDF), 21 fatty liver(F) only and 18 control subjects(C). Homeostasis model assessment(HOMA) was applied to assess the status of insulin resistance. Results The results showed that body mass index(BMI), waist circumference(W1), waist hip ratio(WHR), serum cholesterol(TC), serum triglyceride(TG), alanine aminotransferase(ALT), aspartate aminotransferase(AST) and HOMA IR were significantly elevated in the subjects of DF, and F compared with those of NDF and C( P 0.05). The levels of fasting blood glucose(FBG), 2 hour postprandial blood glucose(2hBG), fasting serum insulin(FINS), 2 hour postprandial serum insulin(2hINS) in patients of F were significantly higher than those of C. FFA was obviously increased in DF patients compared with the control subjects( P 0.05). Multiple stepwise regression analysis showed that fasting glucose, TG, BMI, fatty liver were independent risk factors of insulin resistance in fatty liver patients. Conclusion The present study confirms that insulin resistance is generally present in subjects with fatty liver, even in absence of diabetes. Fasting glucose, TG, BMI, fatty liver are independent risk factors of insulin resistance in patients with fatty liver.