Internal Medicine Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Horm Metab Res. 2021 Feb;53(2):100-104. doi: 10.1055/a-1341-9710. Epub 2021 Jan 29.
It is suggested that estrogen protects premenopausal women against non-alcoholic fatty liver disease. From another perspective, the relation between metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) is bidirectional. Role of insulin resistance (IR) in NAFLD continues to be a matter of debate. The present study aimed to assess the relation between IR and NAFLD in premenopausal women with MetS. The study included 51 premenopausal women with MetS. In addition, there were 40 age-matched healthy controls. All participants were subjected to careful history taking and thorough clinical examination. Performed laboratory investigations included fasting blood glucose, fasting insulin, lipid profile, and liver functions. Calculation of IR was achieved by the Homeostasis Model Assessment (HOMA-IR). NAFLD was graded into three grades according to findings of abdominal ultrasound. Patients had significantly higher BMI, SBP, DBP, FBG, fasting insulin, HOMA-IR, total cholesterol, triglycerides, and LDL levels when compared with controls. They also had significantly lower HDL levels in comparison to controls. Moreover, they have more advanced grades of NAFLD in contrast to controls. Comparison between patients with various grades of NAFLD regarding the clinical data revealed significant increase of fasting insulin and HOMA-IR levels with advancing NAFLD grade. Using multivariate regression analysis, HOMA-IR was an independent predictor of advanced NAFLD grade. In conclusion, the present study documented a combined inter-relation between MetS, IR, and NAFLD in premenopausal women with MetS. IR is correlated with NAFLD grade.
有人认为雌激素能保护绝经前妇女免受非酒精性脂肪肝疾病的侵害。从另一个角度来看，代谢综合征（MetS）和非酒精性脂肪肝疾病（NAFLD）之间的关系是双向的。胰岛素抵抗（IR）在NAFLD中的作用仍存在争议。本研究旨在评估患有 MetS 的绝经前妇女中 IR 与 NAFLD 之间的关系。该研究纳入了 51 名患有 MetS 的绝经前妇女。此外，还有 40 名年龄匹配的健康对照者。所有参与者都接受了详细的病史询问和全面的临床检查。进行的实验室检查包括空腹血糖、空腹胰岛素、血脂谱和肝功能。通过稳态模型评估（HOMA-IR）计算 IR。根据腹部超声检查结果，将 NAFLD 分为三个等级。与对照组相比，患者的 BMI、SBP、DBP、FBG、空腹胰岛素、HOMA-IR、总胆固醇、甘油三酯和 LDL 水平明显更高。与对照组相比，他们的 HDL 水平也明显更低。此外，与对照组相比，他们的 NAFLD 程度更严重。比较不同 NAFLD 程度的患者的临床数据发现，随着 NAFLD 程度的加重，空腹胰岛素和 HOMA-IR 水平显著升高。通过多元回归分析，HOMA-IR 是 NAFLD 严重程度的独立预测因子。总之，本研究记录了绝经前患有 MetS 的妇女中 MetS、IR 和 NAFLD 之间的综合相互关系。IR 与 NAFLD 程度相关。
