Association of nonalcoholic fatty liver disease with abnormal aminotransferase and postprandial hyperglycemia

Goals: This study was conducted to explore the association between nonalcoholic fatty liver disease and glucose metabolism as well as insulin resistance using the homeostasis model assessment method (HOMA). Study: From July 2003 to June 2004, 23 patients with ultrasound-proved fatty liver and either normal (10 patients) or abnormal (13 patients) serum aminotransferase levels were enrolled. Blood tests included a routine biochemistry, a 75-g glucose oral glucose tolerance test (OGTT) with blood sampled at 30-minute intervals during a 120-minute period. Fasting and 120-minute serum leptin, insulin, and C-peptide concentrations were also measured. Results: Using the Mann-Whitney U test, significant differences were found in gamma glutamyl transpeptidase (28.6 +/- 7.9 vs. 65.1 +/- 65.9 U/L, P = 0.008), fasting insulin (FI) (13.11 +/- 7.53 vs. 31.76 +/- 42.95 mu U/mL, P = 0.02), fasting C-peptide (3.82 +/- 3.00 vs. 2.17 +/- 0.43 ng/mL, P = 0.01), fasting leptin (10.34 +/- 4.05 vs. 24.27 +/- 24.97 ng/mL, P = 0.01), HOMA-IR (3.34 +/- 1.06 vs. 8.81 +/- 13.18, P = 0.02), and HOMA beta-cell function (120.32 +/- 52.50 vs. 242.20 +/- 247.29, P = 0.02) between normal and abnormal ALT/AST function groups. From the 75-g OGTT, no significant difference of plasma glucose was noted at 0, 30, 60, and 90 minutes but significant change was noted in 120-minute plasma glucose (99.3 +/- 21.5 vs. 131.4 +/- 27.3 mg/dL, P = 0.004) of 2 groups. Conclusions: In conclusion, patients with fatty liver proved by ultrasound sonography might be at high risk of developing type 2 diabetes, especially when they had elevated liver enzymes. OGTT is warranted for the early diagnosis of these high risk patients.