(26-06-12) Non-alcoholic fatty liver disease, insulin resistance and ectopic fat: a new problem in diabetes management.

Byrne CD.
Source
Endocrinology and Metabolism, University Hospital Southampton and University of Southampton, Southampton, UK.
Abstract
Non-alcoholic fatty liver disease is now recognized as the hepatic component of the metabolic syndrome. Non-alcoholic fatty liver disease is a spectrum of fat-associated liver conditions that can result in end-stage liver disease and the need for liver transplantation. Simple steatosis, or fatty liver, occurs early in non-alcoholic fatty liver disease and may progress to non-alcoholic steatohepatitis, fibrosis and cirrhosis with increased risk of hepatocellular carcinoma. Prevalence estimates for non-alcoholic fatty liver disease range from 17 to 33% in the general populations and it has been estimated that 2 non-alcoholic fatty liver disease exists in up to 70% of people with Type 2 diabetes diabetes. Non-alcoholic fatty liver disease increases risk of Type 2 diabetes, non-alcoholic fatty and cardiovascular disease. In people with Type liver disease is the most frequent cause (∼80%) of fatty liver diagnosed by ultrasound. As non-alcoholic fatty liver disease is strongly associated with insulin resistance, the presence of non-alcoholic fatty liver disease with diabetes often contributes to poor glycaemic control. Consequently, strategies that decrease liver fat and improve whole-body insulin sensitivity may both 2 diabetes and to better glycaemic control in contribute to prevention of Type people who already have developed diabetes. This review summarizes the Dorothy Hodgkin lecture given by the author at the 2012 Diabetes UK annual scientific conference, proposing that fatty acid fluxes through the liver are crucial for the pathogenesis of non-alcoholic fatty liver disease and for increasing insulin resistance. ? 2012 The Authors. Diabetic Medicine ? 2012 Diabetes UK.

Source: Diabet Med. 2012 Jun 4. doi: 10.1111/j.1464-5491.2012.03732.x. [Epub ahead of print]

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