Metabolic-Associated Fatty Liver Disease is Characterized by a Post-Oral Glucose Load Hyperinsulinemia in Individuals with Mild Metabolic Alterations

Am J Physiol Endocrinol Metab. 2024 Mar 13. doi: 10.1152/ajpendo.00294.2023. Online ahead of print.ABSTRACTMetabolic-associated fatty liver disease (MAFLD) has been identified as risk factor of incident type 2 diabetes (T2D), but the underlying postprandial mechanisms remains unclear. We compared the glucose metabolism, insulin resistance, insulin secretion and insulin clearance post-oral glucose tolerance test (OGTT) between individuals with and without MAFLD. We included 50 individuals with a BMI between 25-40 kg/m2 and ≥1 metabolic alteration: increased fasting triglycerides or insulin, plasma glucose 5.5-6.9 mmol/L, or glycated hemoglobin 5.7-5.9%. Participants were grouped according to MAFLD status, defined as hepatic fat fraction (HFF) ≥5% on MRI. We used oral minimal model on a frequently sampled 3h 75g-OGTT to estimate insulin sensitivity, insulin secretion, and pancreatic ß-cell function. Fifty percents of participants had MAFLD. Median age (IQR) (57 (45-65) vs 57 (44-63) years) and gender (60% vs 56% female) were comparable between groups. Post-OGTT glucose concentrations did not differ between groups, whereas post-OGTT insulin concentrations were higher in the MAFLD group (p <0.03). Individuals with MAFLD exhibited lower insulin clearance, insulin sensitivity and first phase pancreatic β cell function. In all individuals, increased insulin incremental area under the curve and decreased insulin clearance were associated with HFF after adjusting for age, sex...
Source: Am J Physiol Endocri... - Category: Endocrinology Authors: Source Type: research