Hepatic steatosis and insulin resistance: does etiology make a difference?

J Hepatol. 2006 Jan;44(1):190-6. doi: 10.1016/j.jhep.2005.06.018. Epub 2005 Jul 12.


Background/aims: To ascertain whether the etiology of hepatic steatosis modulates insulin resistance (IR) and to determine the predictors of IR.

Methods: We studied IR through HOMA IR in 146 subjects, 99 of whom had ultrasonographic and/or histologic steatosis. Twenty-two had familial heterozygous hypobetalipoproteinemia (FHBL), 48 had non-alcoholic fatty liver disease (NAFLD), 34 HCV infection (17 with HCV1b, 17 with HCV3a) and 42 were healthy controls without steatosis.

Results: Steatosis was present in 77.3% of FHBL and, by enrolment criteria, in all NAFLD and HCV cases. Overall HOMA-IR correlated with BMI and GGT (P<0.01). FHBL and healthy groups had similar HOMA-IR and GGT values, whereas higher levels were observed in HCV and NAFLD. HCV3a and FHBL patients were hypolipidemic. HOMA-IR was similar in FHBL patients and controls and lower than in HCV and NAFLD. FHBL patients had a high extent of steatosis, similar to that observed in HCV3a, but lower grading and staging than NAFLD and HCV. At multivariate analysis, steatosis and GGT predicted HOMA-IR.

Conclusions: Data suggest that not all hepatic fat associates with IR. FHBL patients, for some aspects, resemble HCV3a infection, possibly suggesting a shared steatogenic mechanism. Among steatotic patients serum GGT levels is the independent predictor of IR.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biopsy
  • Blood Glucose / metabolism
  • Disease Progression
  • Fatty Liver / blood
  • Fatty Liver / diagnosis
  • Fatty Liver / etiology*
  • Female
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / metabolism
  • Humans
  • Hyperlipoproteinemia Type II / complications
  • Hyperlipoproteinemia Type II / metabolism
  • Insulin Resistance*
  • Liver / diagnostic imaging
  • Liver / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Risk Factors
  • Ultrasonography
  • gamma-Glutamyltransferase / blood


  • Biomarkers
  • Blood Glucose
  • gamma-Glutamyltransferase