Research Article Details

Article ID: A11975
PMID: 30660761
Source: Diabetes Metab
Title: Insulin resistance and NAFLD: Relationship with intrahepatic iron and serum TNF-α using 1H MR spectroscopy and MRI.
Abstract: AIM: The association of non-alcoholic fatty liver disease (NAFLD) with insulin resistance (IR) is well established, yet little is known of their possible relationship with intrahepatic iron and serum tumour necrosis factor (TNF)-&#945; concentrations in adults without diabetes. Thus, this study looked at the relationship of intrahepatic iron and serum TNF-&#945; with intrahepatic triglycerides and IR in non-diabetic adults. METHODS: In this cross-sectional study of 104 healthy non-diabetic Caucasians, a quantitative magnetic resonance (MR) imaging T2 gradient-echo technique was used to measure hepatic iron, with 1H-MR spectroscopy used to measure hepatic triglycerides. HOMA-IR was calculated to determine IR. RESULTS: The prevalence of hepatic iron overload (HIOL) was 26.6% in individuals with NAFLD vs. 0% in those without. IR was present in 87.5% of subjects with both NAFLD and HIOL, in 45.4% of those with NAFLD but not HIOL, and in 4.5% of those with neither. HOMA-IR was positively correlated with hepatic triglycerides (r&#8201;=&#8201;0.56, P&#8201;<&#8201;0.001) and hepatic iron (r&#8201;=&#8201;0.52, P&#8201;<&#8201;0.001), whereas serum TNF-&#945; concentrations correlated with intrahepatic triglyceride levels (r&#8201;=&#8201;0.28, P&#8201;<&#8201;0.04), but not with intrahepatic iron. Hepatic triglycerides, serum TNF-&#945; and age were the only significant determinants of IR in regression analyses. CONCLUSION: IR is closely associated with intrahepatic triglycerides and, to a lesser extent, intrahepatic iron, with some interplay between them. High serum TNF-&#945; concentrations may contribute to the association between NAFLD and IR, while increased hepatic triglycerides appear to be a determinant of the development of HIOL in non-diabetic subjects without haemochromatosis.
DOI: 10.1016/j.diabet.2019.01.005