Definitions of Normal Liver Fat and the Association of Insulin Sensitivity with Acquired and Genetic NAFLD - A Systematic Review

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Petäjä , E M & Yki-Järvinen , H 2016 , ' Definitions of Normal Liver Fat and the Association of Insulin Sensitivity with Acquired and Genetic NAFLD - A Systematic Review ' , International Journal of Molecular Sciences , vol. 17 , no. 5 , 633 . https://doi.org/10.3390/ijms17050633

Title: Definitions of Normal Liver Fat and the Association of Insulin Sensitivity with Acquired and Genetic NAFLD - A Systematic Review
Author: Petäjä, Elina M.; Yki-Järvinen, Hannele
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2016-05
Language: eng
Number of pages: 16
Belongs to series: International Journal of Molecular Sciences
ISSN: 1422-0067
URI: http://hdl.handle.net/10138/165225
Abstract: Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of disease ranging from simple steatosis (NAFL) to non-alcoholic steatohepatitis (NASH) and fibrosis. "Obese/Metabolic NAFLD" is closely associated with obesity and insulin resistance and therefore predisposes to type 2 diabetes and cardiovascular disease. NAFLD can also be caused by common genetic variants, the patatin-like phospholipase domain-containing 3 (PNPLA3) or the transmembrane 6 superfamily member 2 (TM6SF2). Since NAFL, irrespective of its cause, can progress to NASH and liver fibrosis, its definition is of interest. We reviewed the literature to identify data on definition of normal liver fat using liver histology and different imaging tools, and analyzed whether NAFLD caused by the gene variants is associated with insulin resistance. Histologically, normal liver fat content in liver biopsies is most commonly defined as macroscopic steatosis in less than 5% of hepatocytes. In the population-based Dallas Heart Study, the upper 95th percentile of liver fat measured by proton magnetic spectroscopy (1H-MRS) in healthy subjects was 5.6%, which corresponds to approximately 15% histological liver fat. When measured by magnetic resonance imaging (MRI)-based techniques such as the proton density fat fraction (PDFF), 5% macroscopic steatosis corresponds to a PDFF of 6% to 6.4%. In contrast to "Obese/metabolic NAFLD", NAFLD caused by genetic variants is not associated with insulin resistance. This implies that NAFLD is heterogeneous and that "Obese/Metabolic NAFLD" but not NAFLD due to the PNPLA3 or TM6SF2 genetic variants predisposes to type 2 diabetes and cardiovascular disease.
Subject: insulin resistance
liver fat
obesity
PNPLA3
TM6SF2
MAGNETIC-RESONANCE-SPECTROSCOPY
MORBIDLY OBESE-PATIENTS
HEPATIC STEATOSIS
COMPUTED-TOMOGRAPHY
I148M VARIANT
CONFERS SUSCEPTIBILITY
CARDIOVASCULAR-DISEASE
TRIGLYCERIDE CONTENT
DIAGNOSTIC-ACCURACY
METABOLIC SYNDROME
3121 General medicine, internal medicine and other clinical medicine
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