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Insulin resistance in patients with steatohepatitis
Kenan Saglam1, Recai Kiliç, M Ilker Yilmaz
1Dept. of Internal Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey 06018. ksaglam@gata.edu.tr
Background/Aims:
Steatohepatitis is a disease characterized with liver damage due to fat accumulation in more than 5% of the liver weight associated with alcohol intake (consumption) and other (various) causes. However, alcoholic and non-alcoholic steatohepatitis do not differ histologically. The aim of study was to investigate whether or not insulin resistance exists in patients with steatohepatitis. Further investigations are needed to show what the mechanisms leading to insulin resistance are.
Methodology:
We used a hyperinsulinemic euglycemic clamp to tissue sensitivity to insulin in 11 patients (10 males and one female) and 10 healthy age- and sex-matched individuals. A diagnosis of steatohepatitis was made by clinical, laboratory and histological findings.
Results:
The amount of glucose infused which is required to keep euglycemia (M value) was markedly low in the study group than in the controls (2.24 +/- 0.33 mg/kg/min and 7.45 +/- 0.82 mg/kg/min, respectively p < 0.0001) suggesting insulin resistance (M value < 4 mg/kg/min).
Conclusions:
Our findings demonstrate that insulin resistance does exist in patients with steatohepatitis and the pathophysiological mechanisms causing resistance is not clear but insulin action is an issue of further investigation.