Document Detail

Alterations in lipid, carbohydrate and iron metabolism in patients with non-alcoholic steatohepatitis (NASH) and metabolic syndrome.
MedLine Citation:
PMID:  21570653     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: NASH (non-alcoholic steatohepatitis) is considered the hepatic manifestation of the metabolic syndrome (MS). We aimed to analyze lipid, carbohydrate, and iron metabolism in NASH.
PATIENTS, METHODS: 37 patients with MS (17 M/20 F, 51+/-15years), elevated transaminases; 25 patients had histologically proven NASH (NAS score≥5), 12 patients had toxic background (nonNASH). 37 age, sex, BMI-matched healthy controls. Lipid variables, LDL-subfractions, iron, ferritin, transferrin (T), transferrin saturation (TS), and hepcidin (H) were measured in patients/controls. Oral glucose tolerance tests were performed.
RESULTS: NASH patients with steatosis gr. 2 and 3 (>33% hepatic fat) had higher sd-LDL (mg/dl) concentrations than patients with steatosis gr. 1 (<33%) (p=0.002), nonNASH patients (p=0.03) and controls (p=0.001). Sd absolute (mg/dl) correlated directly with the steatosis grade only in patients with NASH and steatosis >33% (p=0.04). NASH-patients showed higher insulin, C-peptide and IRI values than nonNASH patients (p=0.034; 0.032; 0.04). H was increased in patients versus controls (p<0.001). H correlated with ferritin in MS-patients (p=0.01), correlated directly with sd-LDL (mg/dl) (p=0.017) and IRI (p<0.001) and indirectly with HDL (p=0.05) in NASH. No associations between hepatic inflammation/iron content on liver biopsy and variables of lipid metabolism were found but hepcidin correlated with hepatic inflammation in all patients and with NAS scores in NASH.
CONCLUSIONS: NASH-patients show insulin resistance and increased sd-LDL subfractions, suggesting an atherogenic profile. The correlation of H with sd-LDL and IRI, without relation to hepatic iron content suggests a putative link between inflammation, carbohydrate and lipid metabolism in NASH.
Anca Zimmermann; Tim Zimmermann; Jörn Schattenberg; Sebastian Pöttgen; Johannes Lotz; Heidi Rossmann; Ralf Roeddiger; Stefan Biesterfeld; Hans-Christian Geiss; Marcus Schuchmann; Peter R Galle; Matthias M Weber
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Publication Detail:
Type:  Journal Article     Date:  2011-02-12
Journal Detail:
Title:  European journal of internal medicine     Volume:  22     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  305-10     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
1st Medical Clinic, Dept. of Endocrinology and Metabolic Diseases, Johannes Gutenberg University of Mainz, Germany.
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