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Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients

International Journal of Obesity volume 28, pages 167–172 (2004)Cite this article

Abstract

OBJECTIVES: The aims of this study were to test the possible association between nonalcoholic fatty liver disease (NAFLD) and iron and insulin resistance, and to determine the prevalence of NAFLD in apparently healthy obese subjects.

DESIGN: Cross-sectional, clinical epidemiologic study.

SUBJECTS: A total of 210 apparently healthy obese patients, aged from 18 to 65 y, with a body mass index (BMI) of 28 kg/m2 or more, were enrolled in a body weight reduction program in our hospital.

MEASUREMENTS: All the subjects underwent screening and preprogram examinations, including anthropometric data measurements, biochemistry testing, and ultrasonography of the liver. NAFLD was defined as fatty liver diagnosed by ultrasonograpgy plus persistent elevation of alanine aminotransferase (ALT) levels.

RESULTS: Of the 210 patients, 80% (168/210) had fatty liver. Persistent ALT elevation in two separate tests was further detected in 25.6% (43/168) of patients. Multiple logistic regression analysis showed waist circumference and insulin resistance to be independently associated with fatty liver. Serum ferritin level and insulin resistance were two major risk factors predicting NAFLD.

CONCLUSION: The prevalence of NAFLD was 20.5% (43/210) in obese patients. As both hyperinsulinemia induced by insulin resistance and iron overload represented by ferritin elevation might damage hepatocytes, we concluded that these two factors were significantly associated with NAFLD in obese patients.

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Acknowledgements

This study was partially supported by a National Science Council Grant NSC 91-2320-B002-082-M56. This work was also partially supported by the Taiwan branches of Roche Pharmaceuticals and Abbott Laboratories Services Corporation, and Kaho Biotech Corporation for the body weight reduction programs. We are grateful to dietician Tzi-yi Lin for dietary instructions to our patients, and to Ms Ya-huei Chiu, Chiu-hui Yu, and Yi-ping Tseng for their assistance with data management.

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  1. Department of Internal Medicine, Tao-Yuan General Hospital, Taiwan

    T-J Hsiao & J-C Chen

  2. Department of Internal Medicine, National Taiwan University Hospital, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taiwan

    J-D Wang

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  1. T-J Hsiao
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  3. J-D Wang
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Correspondence to J-D Wang.

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Hsiao, TJ., Chen, JC. & Wang, JD. Insulin resistance and ferritin as major determinants of nonalcoholic fatty liver disease in apparently healthy obese patients. Int J Obes 28, 167–172 (2004). https://doi.org/10.1038/sj.ijo.0802519

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