Non-alcoholic fatty liver: another feature of the metabolic syndrome?

Background and aims: Hepatic steatosis and nonalcoholic steatohepatitis (NA SH) have been associated with obesity, non insulin-dependent diabetes melli tus and hyperlipidemia. The present study was designed in order to evaluate whether patients with steatosis/NASH presented common features with the me tabolic syndrome. Methods: In 30 patients with nonalcoholic fatty liver the prevalence of hyp ertension and diabetes; the glucose/insulin profile, lipid profile, and ser um leptin were evaluated and correlated with body composition and energy ex penditure, assessed by bioimpedance spectroscopy and indirect calorimetry, respectively. Results were compared with a group of eight controls. Results: Obesity was present in 80% of patients, hypertension in 50% and no n insulin dependent diabetes in 33%. Glucose metabolism was altered in 69%, with elevated insulin in 14 patients. Serum leptin, higher in women, was i ncreased in patients: 33.9 +/- 38.9 vs 9.6 +/- 6.9 ng/ml, P < 0.05. There w as a correlation between insulin and leptin, both of which correlated with body mass index, fat mass and percentage of body fat. Dyslipidaemia was fou nd in 80% of patients: 45% presented low high density lipoproteins choleste rol, 58% high low density lipoproteins and 38% elevated very low density li poproteins. Conclusions: There is a strong association between nonalcoholic fatty liver and features of the metabolic syndrome, suggesting a simultaneous insulin resistance and decreased sensitivity to leptin. (C) 1999 Harcourt Publisher s Ltd.