CORRELATION OF FLI FATTY LIVER INDEX WITH INSULIN RESISTANCE INDICES IN PATIENTS WITH METABOLIC SYNDROME
Abstract
CORRELATION OF FLI FATTY LIVER INDEX WITH INSULIN RESISTANCE INDICES IN PATIENTS WITH METABOLIC SYNDROME
Аuthor: Marija Mitrović, Vojko Mišević
e-mail: mitrovicmarija505@gmail.com, misevic.vojko@gmail.com
Mentor: TA Ljiljana Popović, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia
e-mail: liliana.popovich@gmail.com
Introduction: Metabolic syndrome includes insulin resistance, visceral obesity, hypertension and dyslipidemia, which together lead to increased risk of atherosclerosis, cardiovascular diseases, diabetes mellitus. Insulin resistance is considered a pathophysiological mechanism underlying metabolic syndrome, characterized by inadequate glucose metabolism, hyperinsulinemia and lipid imbalance. Non-alcoholic fatty liver disease is a chronic disease characterized by microvesicular steatosis and isn’t consequence of the use of drugs, alcohol or inherited diseases and is hepatic manifestation of metabolic syndrome.
The Aim: Since insulin resistance is pathophysiologically related to metabolic liver diseases, the aim of this study was to investigate correlation of the FLI index with insulin resistance indices (HOMA, Tyg, QUICKI) in complete sample, but also at the level of groups of overweight and obese patients.
Мaterial and Methods: Study included 70 patients who met the criteria for the diagnosis of metabolic syndrome and who were randomly selected from medical documentations from the Cabinet for lipid disorders and lipopheresis, Clinic for Endocrinology KCS. Patients were divided into two groups. Group A were overweight patients (BMI 25-29.9 kg/m2). Group B were obese patients (BMI>30 kg/m2). Insulin resistance index values were compared between groups and then correlated by statistical analysis with FLI index within groups and in a complete sample.
Results: Statistical analysis found correlation between the FLI index and the insulin resistance indices, HOMA and Tyg (p=0.03; p<0.001) in a complete sample. A statistically significant difference in the values of the FLI index between the examined groups was proved (p=0.001).
Conclusion: The positive correlation between the FLI index with the Tyg and HOMA indices speaks in favor of the interrelationship between insulin resistance and fatty liver in patients with metabolic syndrome. In this case insulin resistance can be a predictor for the development of non-alcoholic fatty liver disease, steatosis, steatohepatitis, hepatocellular carcinoma and cardiovascular diseases.
Кeywords: metabolic syndrome; insulin resistance; FLI index
References
1. Roberts CK, Hevener AL, Barnard RJ. Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Compr Physiol. 2013; 3(1):1-58.
2. Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009; 2(5-6):231-7.
3. Mendizabal Y, Llorens S, Nava E. Hypertension in metabolic syndrome: vascular pathophysiology. Int J Hypertens. 2013; 2013:230868.
4. Ighbariya A, Weiss R. Insulin Resistance, Prediabetes, Metabolic Syndrome: What Should Every Pediatrician Know?. J Clin Res Pediatr Endocrinol. 2017; 9:49-57.
5. Gutch M, Kumar S, Razi SM, Gupta KK, Gupta A. Assessment of insulin sensitivity/resistance. Indian J Endocrinol Metab. 2015; 19(1):160-164.
6. Gayoso-Diz P, Otero-González A, Rodriguez-Alvarez MX, Gude F, García F, De Francisco A, et al. Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013; 13:47.
7. Salazar J, Bermudez V, Calvo M, Olivar LC, Luzardo E, Navarro C et al. Optimal cut off for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population. F1000Res. 2017; 6:1337.
8. Chen H, Sullivan G, Yue LQ, Katz A, Quon MJ. QUICKI is a useful index of insulin sensitivity in subjects with hypertension. Am J Physiol Endocrinol Metab. 2003; 284(4):E804-12.
9. Motamed N, Sohrabi M, Ajdarkosh H, Hemmasi G, Maadi M, Sayeedian FS et al. Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease. World J Gastroenterol. 2016; 22(10):3023-30.
10. Kahl S, Straßburger K, Nowotny B, Livingstone R, Klüppelholz B, Keßel K et al. Comparison of liver fat indices for the diagnosis of hepatic steatosis and insulin resistance. PLoS One. 2014; 9(4):e94059.
11. Fedchuk L, Nascimbeni F, Pais R, Charlotte F, Housset C, Ratziu V et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014; 40(10):1209-22
12. Martinez KE, Tucker LA, Bailey BW, LeCheminant JD. Expanded Normal Weight Obesity and Insulin Resistance in US Adults of the National Health and Nutrition Examination Survey. J Diabetes Res. 2017; 2017:9502643.
13. Watt MJ, Miotto PM, De Nardo W, Montgomery MK. The Liver as an Endocrine Organ- Linking NAFLD and Insulin Resistance. Endocr Rev. 2019; 40(5):1367-1393.
14. Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999; 107(5):450-5.
15. McCullough A, Previs SF, Dasarathy J, Lee K, Osme A, Kim C et al. HDL flux is higher in patients with nonalcoholic fatty liver disease. Am J Physiol Endocrinol Metab. 2019; 317(5):E852-E862.