Research Article Details

Article ID: A18440
PMID: 27134062
Source: Nutr Metab Cardiovasc Dis
Title: Insulin resistance, postprandial GLP-1 and adaptive immunity are the main predictors of NAFLD in a homogeneous population at high cardiovascular risk.
Abstract: BACKGROUND AND AIMS: The role of the different factors associated with fatty liver is still poorly defined. We evaluated the relationships between liver fat content (LF) and metabolic, inflammatory and nutritional factors in a homogeneous cohort of individuals at high cardio-metabolic risk. METHODS AND RESULTS: In 70 individuals with high waist circumference and at least one more criterion for metabolic syndrome enrolled in a nutritional intervention study, LF was evaluated at baseline by hepatic/renal echo intensity ratio (H/R), together with dietary habits (7-day dietary record), insulin sensitivity and &#946;-cell function (fasting and OGTT-derived indices), fasting and postprandial plasma GLP-1 and lipoproteins, and plasma inflammatory markers. H/R correlated positively with fasting and OGTT plasma glucose and insulin concentrations, HOMA-IR and &#946;-cell function, and IL-4, IL-17, IFN-&#947;, TNF-&#945;, FGF and GCSF plasma concentrations (p&#160;<&#160;0.05 for all), and negatively with insulin sensitivity (OGIS), dietary, polyphenols and fiber (p&#160;<&#160;0.05 for all). By multiple stepwise regression analysis, the best predictors of H/R were OGIS (&#946;&#160;=&#160;-0.352 p&#160;=&#160;0.001), postprandial GLP-1 (&#946;&#160;=&#160;-0.344; p&#160;=&#160;0.001), HDL-cholesterol (&#946;&#160;=&#160;-0.323; p&#160;=&#160;0.002) and IFN-&#947; (&#946;&#160;=&#160;0.205; p&#160;=&#160;0.036). CONCLUSION: A comprehensive evaluation of factors associated with liver fat, in a homogeneous population at high cardio-metabolic risk, indicated a pathogenic combination of the same pathways underlying the atherosclerotic process, namely whole body insulin sensitivity and inflammation. The higher predictive value of postprandial variables suggests that liver fat is essentially a postprandial phenomenon, with a relevant role possibly played by GLP-1. REGISTRATION NUMBER FOR CLINICAL TRIALS: NCT01154478.
DOI: 10.1016/j.numecd.2016.01.011