BACKGROUND: The conditions associated with fatty liver disease presenting
with normal liver enzymes and the mechanism in its development
remain to be fully investigated.
AIMS: The aim of this work was to test the hypothesis that fatty liver
with normal liver enzymes occurs most frequently in arterial hypertensive
patients and to establish whether this is associated with insulin resistance.
PABENTS: Fifty five non-obese, non-diabetic, non-alcoholic patients
with arterial hypertensive and normal liver enzymes and 55 sex and age
matched healthy subjects (control group) were enrolled into the study.
METHODS: Plasma metabolic parameters, body mass index, and the
presence of fatty liver were investigated. Insulin resistance was estimated
from plasma insulin and glucose. Stepwise logistic regression and
multivariate regression analysis were used on the combined sample to
identify variables inriPpenclently associated with fatty liver and insulin
resistance.
RESULTS: Hypertensive patients had a significantly higher prevalence
of fatty liver (30.9% v 12.7%; p>0.041), higher insulin resistance (mean
2.27(SD 1.81) v 1.56(0.70); p = 0.022), and slightly higher body mass index
(24.9 (3.0) v 24.0 (2.2); p = 0.043) than controls. Multivariate logistic
regression identified insulin resistance (odds ratio 1.66(95% confidence
interval (Cl) 1.03-2.52)) and body mass index (OR 1.22 (95% Cl 1.00-
1.49)) as factors independently associated with fatty liver. Multivariate
regression analysis showed insulin resistance to be predicted by alanine
transaminase (p=0.002), presence of arterial hypertension (p=0.029), and
body mass index (p=0.048).
CONCLUSION: The higher prevalence of non-alcoholic fatty liver in nonobese
hypertensive patients with normal liver enzymes appears to be related
to increases in insulin resistance and body weight |
