Metabolic disturbances of non-alcoholic fatty liver resemble the alterations typical for type 2 diabetes

We examined metabolic perturbations in people with NAFL, patients with T2DM and people with normal intrahepatic lipid (IHL) (CON). A 2-step (10mU/m2/min, 40mU/m2/min) hyperinsulinemic-euglycemic clamp was performed in 11 NAFL, 13 T2DM and 11 CON, all matched for BMI and aerobic fitness. IHL was measured using proton magnetic resonance spectroscopy. Because of high IHL variability in T2DM patients, this group was separated into a high IHL (IHL≥5.0%, T2DM+NAFL) and a normal IHL (IHL<5.0%, T2DM-non-NAFL) group for further analysis.IHL was increased in NAFL and T2DM+NAFL (p<0.050 vs. CON and T2DM-non-NAFL). Adipose tissue insulin sensitivity index (Adipo-IRi) was higher in NAFL (p<0.050 vs. CON and T2DM-non-NAFL) and in T2DM+NAFL (p=0.055 vs. CON, p<0.050 vs. T2DM-non-NAFL). Suppression of plasma free fatty acids (p=0.046) was lower in NAFL compared to CON, with intermediate values for T2DM-non-NAFL and T2DM+NAFL. Suppression of endogenous glucose production and insulin-stimulated glucose disposal (delta Rd) was comparable between NAFL, T2DM-non-NAFL and T2DM+NAFL (all p>0.05), and was lower in comparison to CON (all p<0.01). Metabolic flexibility was lower in T2DM-non-NAFL (p=0.047) and NAFL (p=0.059) compared to CON. Adipo-IRi (r=0.652, p<0.001), hepatic insulin resistance index (HIRi) (r=0.576, p=0.001), and delta Rd (r=-0.653, p<0.001) correlated with IHL. People with NAFL suffer from metabolic perturbations to a similar degree as T2DM patients. NAF...
Source: Clinical Science - Category: Biomedical Science Authors: Tags: PublishAheadOfPrint Source Type: research