Factors Related with Non-Alcoholic Fatty Liver Disease in Normolipidemic Patients with 1-Hour Hyperglycemia

ABSTRACT

Purpose: Oral glucose tolerance tests (OGTT) use fasting and 120-minute values for the diagnosis of diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), however, in the medical literature, various studies suggest the probable importance of one-hour hyperglycaemia. Non-alcoholic fatty liver disease (NAFLD) is also shown to be related with insulin resistance and cardiovascular risks. We aimed to evaluate the factors related with NAFLD in patients with elevated one-hour plasma glucose levels in the absence of IGT or IFG, hyperlipidemia and hypertension.
Material and Method: Among 746 subjects who underwent physical examination, evaluation of drug and alcohol use, lipid profiles, transaminases, and hepatitis markers as well as OGTT, 69 patients (21 males, 48 females) had 1-hour glucose levels higher than 155 mg/dL. The hepatic steatosis ultrasound examination was conducted to grade (between 0 and 3) the presence of fat within the liver parenchyma. Ordinal regression analysis was performed to evaluate factors related with the degree of liver steatosis.
Results: Overall, hepatosteatosis grade was significantly related with glycohemoglobin (HbA1c) levels, gender and obesity (body mass index≥30kg/m2). Considering only non-obese patients, ultrasonographic grading was significantly associated with age and homeostasis model assessment (HOMA) of insulin resistance.
Discussion: Even if the diagnosis of diabetes, IGT and IFG is not established, insulin resistance can be related with hepatosteatosis and elevated HbA1c level and, homeostasis model assessment may be predictive for NAFLD grade on ultrasonography in patients with high 60-minute glycaemia on standard 75-g OGTT.