Insulin Resistance and Metabolic Syndrome in Patients with Non-Alcoholic Fatty Liver Disease

Document Type : Original Article


1 Environmental Medical Sciences ,Department of Nutritional Requirements

2 Environmental Medical Sciences, Growth , National Nutrition Institute

3 Environmental Medical Sciences Department of Field Researches and Studies,National Nutrition Institute


Nonalcoholic fatty liver disease (NAFLD) is closely related to obesity and insulin resistance (IR), and it is generally agreed upon that NAFLD is the hepatic manifestation of metabolic syndrome (MetS). MetS is an insulin resistance syndrome comprising glucose intolerance, IR, central obesity, dyslipidemia, and hypertension, all of which are well-established risk factors for cardiovascular disease (CVD).The aim of this study is to assess the prevalence of IR in non-diabetic adult patients with (NAFLD) and its relation with Mets. This study included 40 non-diabetic patients with (NAFLD). We performed full history taking and clinical examination with anthropometric measurements for the patients studied. Investigations included serum analysis for liver functions, fasting and postprandial blood glucose, lipid profile, fasting insulin, and homeostasis model assessment insulin resistance index (HOMA-IR). Patients with HOMA-IR levels ≥ 2 were considered insulin resistant. MetS was assessed according to International Diabetic Federation (IDF) criteria. Abdominal ultrasound was performed for NAFLD diagnosis and exclusion of cirrhosis. Insulin resistance was found in 62.5% of NAFLD patients; their mean age (42.6 ± 8.61 vs. 37.3 ± 6.89 years; p=0.038), triglyceride level (TG) (121.1 ± 79.3 vs. 77.4 ± 23.5 mg/dl; p=0.049) and postprandial blood glucose (PPBG) level (111.1 ± 12.4 vs. 102.7 ± 9.9 mg/dl; p=0.013) respectively were significantly higher compared to those without IR. Fifty percent of NAFLD patients fulfilled criteria of MetS. Obesity and PPBG were statistically higher and HDL-cholesterol level was statistically lower in NAFLD patients with MetS co of obesity and MetS. Patients with NAFLD and MetS are more insulin resistant even in the absence of diabetes. This knowledge may lead to more aggressive management of the MetS risk factors and may lead to improvement in patient's liver disease.