Abstract
Objective
To study hepatic gluconeogenesis pathway in non-diabetic Asian Indian males having
non-alcoholic fatty liver disease (NAFLD) using in vivo (31P) phosphorous magnetic resonance spectroscopy (MRS) and correlate these data with
anthropometry and insulin resistance.
Research design and methods
Forty non-diabetic patients with NAFLD and 20 healthy controls were divided into (i)
obese with NAFLD (group I, n = 20), (ii) non-obese with NAFLD (group II, n = 20) and (iii) non-obese without NAFLD (group III, n = 20). Anthropometric and biochemical profiles, short insulin tolerance test (SITT),
liver ultrasound, and 31P MRS (to determine hepatic gluconeogenesis metabolite; phosphomonoesters (PMEs),
inorganic phosphate (Pi) and their ratios with respect to ATP) were done.
Results
Insulin resistance (Kitt value) was highest in group I (p < 0.05; compared to other two groups), but was also higher in group II as compared to
group III (p = ns). The values of PME/Pi, PME/γATP, PME/βATP, PME/tATP ratios were higher (p < 0.05) in group I compared to other two groups. Interestingly, non-obese subjects with
NAFLD also showed more derangements of hepatic gluconeogenesis metabolites than non-obese
subjects without NAFLD. Positive correlation was observed between PME and other ratios
in relation to body mass index, waist circumference, body fat percentage and fasting
serum insulin levels in all the three groups.
Conclusions
Derangements in hepatic gluconeogenesis as assessed non-invasively using 31P MRS, was observed in obese and non-obese, non-diabetic Asian Indians with NAFLD.
Further research is warranted whether this investigation in NAFLD subjects could be
developed as a non-invasive tool to assess those predisposed to develop hyperglycemia.
Keywords
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Article info
Publication history
Published online: August 04, 2008
Accepted:
June 13,
2008
Received in revised form:
June 9,
2008
Received:
March 14,
2008
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
