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Hepatic steatosis and insulin resistance, but not steatohepatitis, promote atherogenic dyslipidemia in NAFLD

Bril, Fernando; Sninsky, John J.; Baca, Arthur M.; Superko, H. Robert; Sanchez, Paola Portillo; Biernacki, DIane; Maximos, Maryann; Lomonaco, Romina; Orsak, Beverly; Suman, Amitabh; Weber, Michelle H.; McPhaul, Michael J.; Cusi, Kenneth

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2016

10.1210/jc.2015-3111

PMID: 26672634

Abstract:

Context: Patients with nonalcoholic fatty liver disease (NAFLD) are at increased risk of cardiovascular disease, and atherogenic lipoproteins may play an important role. Objective: To determine the contribution of the severity of steatohepatitis to atherogenic dyslipidemia in patients with NAFLD. Design: Cross-sectional Setting: University hospital Patients: Recruited from outpatient clinics or from the general population (n=188). Interventions: Measurement of hepatic triglyceride content by magnetic resonance spectroscopy (1H-MRS); histology (liver biopsy); metabolic profile by means of an oral glucose tolerance test and lipoprotein analyses. Outcomes: Standard lipids, lipoprotein subfraction analysis (apolipoprotein B/A1 levels, LDL particle size/phenotype, and LDL/HDL subfractions), and insulin resistance. Results: Patients with NAFLD had severe insulin resistance, especially at the level of the adipose tissue, when compared to patients without NAFLD. Despite small differences in triglycerides and HDL-...