Epidemiology

Fatty liver in hypertensives tied to insulin resistance

Last Updated: 2004-07-15 7:17:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Fatty liver disease without elevated liver enzymes or other obvious risk factors for such hepatitis steatosis occurs significantly more often in people with arterial hypertension than in the general population and appears to be related to insulin resistance, Italian researchers report in the July issue of Gut.

As Dr. Fabio Piscaglia, who led the study, told Reuters Health, '"non-alcoholic steatohepatitis has become a well defined clinical entity in recent years, signaled by fatty liver and increased liver enzymes, definitively diagnosed at pathological examination of bioptic specimens and caused by insulin resistance." "On the contrary," he added, "the clinical meaning of fatty liver with normal liver enzymes is still largely unknown."

Dr. Piscaglia from the University of Bologna and colleagues report that fatty liver, as detected by abdominal ultrasound, with normal liver enzymes is a relatively common in arterial hypertensive patients.

The researchers found that in 55 non-obese, non-diabetic, non-alcoholic, hepatitis-negative patients with arterial hypertension, the prevalence of fatty liver with normal enzymes was 30.9% versus 12.7% in 55 sex- and age- matched healthy controls.

The presence of this condition appeared independently associated with increased insulin resistance (odds ratio, 1.66) and body mass index (odds ratio, 1.22).

"Since insulin resistance is an important prognostic factor in hypertensive subjects, fatty liver might be a candidate in identifying patients bearing a higher cardiovascular risk," Dr. Piscaglia added.

In an accompanying editorial, Dr. A. M. Diehl from Johns Hopkins University, Baltimore, Maryland, comments that these results "are important because they complement and extend other evidence that correlates hepatic steatosis with insulin resistance." The strong tie between these two conditions, he points out, has "tremendous clinical

relevance."

Gut 2004;53:923-924,1020-1023.