The influence of fatty liver on insulin clearance and insulin resistance in non-diabetic Japanese subjects
Goto, T.; Onuma, T.; Takebe, K.; Kral, J.G.
International Journal of Obesity and Related Metabolic Disorders Journal of the International Association for the Study of Obesity 19(12): 841-845
1995
ISSN/ISBN: 0307-0565 PMID: 8963349 Document Number: 439832
OBJECTIVE: To determine whether fatty liver impairs insulin clearance and contributes to insulin resistance in obese and lean healthy non-diabetic men and women. DESIGN: Cross-sectional, descriptive. SETTING: Medical outpatient clinic; university hospital. SUBJECTS: Twenty-seven (14 men) non-diabetic obese (Body fat % = 31.5+- 9.3; mean +- s.d.) and 19 (13 men) nondiabetic non-obese (body fat % = 19.0 +- 6.8; P lt 0.01 vs obese) healthy subjects aged 31-64 without liver disease. MAJOR OUTCOME MEASURES: Liver density relative to the spleen on CT scan (LFS), glucose infusion rate (GIR) and metabolic insulin clearance rate (MIC) during euglycemic hyperinsulinemic clamp; anthropometric (waist-hip ratio: WHR) and CT-determined (visceral fat area: VFA) measures of fat distribution. RESULTS: Fatty liver was inversely related to MIC (r = -0.39; P lt 0.01) with a positive correlation with fasting p-insulin (r = 0.39; P lt 0.01). There were no statistically significant correlations between BMI, body fat % or WHR and MIC. GIR was inversely related to body fat % (r = -0.49; P lt 0.01), VFA (r = -0.56; P lt 0.01) and WHR (r = -0.36; P lt 0.01) in all subjects, with an inverse relationship to fatty liver in men (r = -0.43; P lt 0.05). CONCLUSION: Increased steatosis of the liver is associated with reduced insulin clearance, contributing to insulin resistance in non-diabetic Japanese men and women.