Naslov
Nonalcoholic Fatty Liver Disease Markers Are Associated with Insulin Resistance in Type 1 Diabetes

Autori
Bulum, Tomislav ; Kolarić, Branko ; Duvnjak, Lea ; Duvnjak, Marko

Izvornik
Digestive diseases and sciences (0163-2116) 56 (2011), 12; 3655-3663

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
nonalcoholic fatty liver disease; liver enzymes; type 1 diabetes; insulin resistance

Sažetak
Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin resistance. Aims was to explore the relationship between markers of NAFLD, namely concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK), c-glutamyltransferase (GGT), ferritin and bilirubin and insulin resistance in type 1 diabetes. Our study included 353 patients with type 1 diabetes. Insulin sensitivity was measured with estimated glucose disposal rate calculated using theequation: eGDR = 24.31 - (12.22 9 WHR) - (3.29 9 HT) - (0.57 9 HbA1c) ; WHR = waist to hip ratio, HT = hypertension. Correlations and multiple logistic regressions analysis were performed to identify the relationships between NAFLD associated markers and eGDR, individual components of insulin resistance and risk of insulin resistance. AST, ALT, AST-to-ALT ratio, ALK and ferritin significantly correlated with insulin resistance measured by eGDR (r = -0.13, -0.14, 0.13, -0.18, and -0.24, respectively ; all P\0.05), and with individual components of insulin resistance, most notably WHR. In a multiple logistic regression model adjusted according to age, sex, duration of diabetes and BMI, increased levels of AST, ALT and ALK resulted in an increased risk for the development of insulin resistance in our subjects (OR = 1.03, 1.02, and 1.01, respectively ; all P\0.05). These findings indicate that higher levels of ALT, AST and ALK are additional markers of insulin resistance in type 1 diabetes and suggest that those subjects must be considered as potentially affected not only by a hepatic but also by a multisystemic disease through altered insulin sensitivity.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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