Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients
Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients
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DOI：
10.1038/sj.ijo.0802519
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发表时间：
2004-01-01
影响因子：
4.9
通讯作者：
Wang, JD
中科院分区：
文献类型：
--
作者：
Hsiao, TJ;Chen, JC;Wang, JD
目的：本研究的目的是检测非酒精性脂肪肝（NAFLD）与铁和胰岛素抵抗之间的可能联系，并确定NAFLD在表面健康的肥胖受试者中的患病率。设计：横断面临床流行病学研究。共有210名明显健康的肥胖患者，年龄从18岁到65岁，体重指数（BMI）为28 kg/m2或更高，参加了我们医院的体重减轻计划。所有的受试者都进行了筛选和程序前检查，包括人体测量数据测量，生化检测和肝脏超声检查。结果：210例患者中80%（168/210）有脂肪肝。25.6%（43/168）的患者在两次单独的检测中进一步检测到持续的ALT升高。多元Logistic回归分析显示腰围和胰岛素抵抗与脂肪肝独立相关。结论：肥胖患者中NAFLD的患病率为20.5%（43/210）。由于胰岛素抵抗引起的高胰岛素血症和铁蛋白升高所代表的铁超载都可能损害肝细胞，我们得出结论，这两个因素与肥胖患者的NAFLD显著相关。
OBJECTIVES: The aims of this study were to test the possible association between nonalcoholic fatty liver disease (NAFLD) and iron and insulin resistance, and to determine the prevalence of NAFLD in apparently healthy obese subjects.DESIGN: Cross-sectional, clinical epidemiologic study.SUBJECTS: A total of 210 apparently healthy obese patients, aged from 18 to 65 y, with a body mass index (BMI) of 28 kg/m(2) or more, were enrolled in a body weight reduction program in our hospital.MEASUREMENTS: All the subjects underwent screening and preprogram examinations, including anthropometric data measurements, biochemistry testing, and ultrasonography of the liver. NAFLD was defined as fatty liver diagnosed by ultrasonograpgy plus persistent elevation of alanine aminotransferase (ALT) levels.RESULTS: Of the 210 patients, 80% (168/210) had fatty liver. Persistent ALT elevation in two separate tests was further detected in 25.6% (43/168) of patients. Multiple logistic regression analysis showed waist circumference and insulin resistance to be independently associated with fatty liver. Serum ferritin level and insulin resistance were two major risk factors predicting NAFLD.CONCLUSION: The prevalence of NAFLD was 20.5% (43/210) in obese patients. As both hyperinsulinemia induced by insulin resistance and iron overload represented by ferritin elevation might damage hepatocytes, we concluded that these two factors were significantly associated with NAFLD in obese patients.