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  • Glucose
  • Basal endogenous glucose production (EGP) and glucose levels did not differ between the two groups, whereas insulin levels tended to be higher in patients compared with controls. (springer.com)
  • Insulin-mediated suppression of EGP during lower dose insulin infusion and insulin-mediated peripheral glucose uptake during higher dose insulin infusion were comparable between FHBL participants and controls. (springer.com)
  • Glucose disposal during the clamp was reduced by nearly 50% in NAFLD patients, as well as in patients with normal body weight, to an extent similar to that of the type 2 diabetic patients. (diabetesjournals.org)
  • 17 ) showed that insulin resistance was the laboratory finding most closely associated with the presence of NAFLD in a large series of patients, irrespective of BMI, fat distribution, or glucose tolerance. (diabetesjournals.org)
  • In a hyperinsulinemic state, which accompanies an influx of refined carbohydrates, insulin inhibits hepatic fatty acid oxidation and instead promotes the use of glucose as a substrate since it is readily available (10). (greenmedinfo.com)
  • Further, metabolic inflexibility, or the "impaired capacity to increase fat oxidation upon increased fatty acid availability and to switch between fat and glucose as the primary fuel source after a meal," accompanies metabolic syndrome (10, p. 178). (greenmedinfo.com)
  • RESEARCH DESIGN AND METHODS - S i was directly measured from frequently sampled intravenous glucose tolerance tests among 999 nondiabetic African-American, Hispanic, and non-Hispanic white subjects aged 40-69 years who were participating in the Insulin Resistance Atherosclerosis Study. (diabetesjournals.org)
  • Subjects also received an oral glucose tolerance test, and fasting insulin, ALT, and alcohol intake were determined. (diabetesjournals.org)
  • The association remained significant after further adjustment for fasting insulin and impaired glucose tolerance ( P = 0.004). (diabetesjournals.org)
  • Detailed measurement of insulin resistance requires the use of techniques (including clamps and intravenous glucose tolerance tests) that are far too costly, time-consuming, and invasive for use in large epidemiological and clinical studies. (diabetesjournals.org)
  • These indexes, which use combinations of insulin and glucose concentrations at various time points during an oral glucose tolerance test, have been validated against direct measures ( 13 - 18 ). (diabetesjournals.org)
  • fibrosis
  • In rodent models fructose consumption has been associated with increased lipogenesis, decreased fatty acid oxidation, increased periportal fibrosis, and impaired endoplasmic reticulum (ER) stress, and impaired insulin signaling. (rapamycintherapy.com)
  • overweight
  • Insulin regulated WISP1 expression in adipocytes in vitro but had no acute effect on WISP1 gene expression in subcutaneous fat tissue in overweight subjects who had undergone hyperinsulinemic clamp experiments. (diabetesjournals.org)
  • patients
  • This concept has stimulated several clinical studies where antidiabetic drugs, such as insulin sensitizers including metformin, have been evaluated in insulin-resistant, NAFLD patients. (hindawi.com)
  • These studies indicate that metformin might be of benefit in the treatment of NAFLD, also in nondiabetic patients, when associated to hypocaloric diet and weight control. (hindawi.com)
  • Moreover, metformin could have beneficial tissue-specific effects in NAFLD patients irrespective of its effects as insulin sensitizer. (hindawi.com)
  • Diet and lifestyle changes are a mainstay in the management of these patients, while specific pharmacologic treatment for NAFLD is so far lacking. (hindawi.com)
  • Therefore, it is not surprising that several studies have evaluated the efficacy of insulin sensitizers in NAFLD patients. (hindawi.com)
  • Patients with NAFLD were reported to have greater fructose consumption. (rapamycintherapy.com)
  • Compared with type 2 diabetic patients, NAFLD patients were characterized by lower basal HGP, but with similarly reduced insulin-mediated suppression of HGP. (diabetesjournals.org)
  • 5 ) identify a syndrome characterized by the association of fatty liver and lobular hepatitis and chronically elevated alanine aminotransferase plasma levels in patients with negligible alcohol intake. (diabetesjournals.org)
  • The initial diagnosis of NAFLD is often suggested incidentally during abdominal ultrasonography as most patients with NAFLD are asymptomatic [ 3 ]. (omicsonline.org)
  • The focus of this article is to explore the link between the human gut microbiota and NAFLD as disruption of the gut microbiota may predispose patients to developing NAFLD. (omicsonline.org)
  • This review summarizes the effects of hypolipidaemic drug combinations (including statins with cholesterol ester protein inhibitors, niacin, fibrates or fish oil, as well as fibrate-ezetimibe combination) on the residual vascular risk in patients with obesity, MetS or T2DM. (benthamopen.com)
  • So, the logical question arises for clinicians, should all patients with diagnosed NAFLD be screened for chronic hepatitis C? (townsendletter.com)
  • 83% of patients had two or more criteria of metabolic syndrome. (alliedacademies.org)
  • homeostasis
  • In other words, "Overnutrition and unabated substrate competition lead to a state of metabolic insensitivity and inflexibility, characterized by distorted nutrient sensing, blunted substrate switching, and impaired energy homeostasis" (11). (greenmedinfo.com)
  • Pathophysiology
  • Beginning with a review of the relevant pathophysiology this article will address the role of the liver and gut microbiota in both metabolic and immune regulation. (omicsonline.org)
  • 1 In this review we focus on primary NAFLD and discuss the current knowledge of the pathophysiology and natural history of NAFLD, appropriate management strategies and emerging treatment options. (cmaj.ca)
  • There is controversy about the specific pathophysiology of metabolic syndrome (MS) but several authors have argued that hyperinsulinemia is a key feature of the cluster. (biomedcentral.com)
  • Epidemiology
  • Understanding of the epidemiology and natural history of NAFLD has increased that the condition is not as "silent" as believed. (mmgazette.com)
  • quartile
  • Compared with the first quartile of TG/HDL-C (Q1), the odds ratios (95% confidence intervals) for NAFLD in the increasing quartiles (Q2-Q4) were 2.1(1.8-2.6), 3.6 (3.0-4.3) and 9.2(7.6-11.1), respectively. (biomedcentral.com)
  • risk
  • Fish oil supplementation maintains proper insulin signaling in the brain, ameliorates NAFLD and decreases the risk to metabolic syndrome suggesting that adequate levels of omega-3 fatty acids in the diet can cope with the metabolic challenges imposed by high fructose intake in Western diets which is of major public health importance. (mdpi.com)
  • Further discussion of specific alterations in the gut microbiota in direct relation to each of the major risk factors for NAFLD will follow. (omicsonline.org)
  • After adjustment for confounding factors, TG/HDL-C was independently associated with the risk of NAFLD. (biomedcentral.com)
  • To evaluate which anthropometric parameter better predicts the high risk of obstructive sleep apnea syndrome (OSA) in a rural population. (sciendo.com)
  • Latinos are at high risk for specific complications from obesity including NAFLD [ 1 ] and insulin resistance compared with other population groups with the prevalence being higher in Latinos of Mexican and Central American origin than Latinos of Caribbean origin [ 2 ]. (hindawi.com)
  • Previous research has demonstrated that there is a clear genetic component (variants of the gene PNPLA3 , I148M) to increased risk for NAFLD in Latinos of Mexican and Central American background [ 3 ]. (hindawi.com)
  • Meanwhile, however, the variant increases risk for women, not men, and Mexican and Central American origin Latinos men are at higher risk for NAFLD than women [ 3 ]. (hindawi.com)
  • These findings suggest that the addition of ALT to existing clinically based metabolic risk definitions is an inexpensive way to improve the identification of subjects with insulin resistance. (diabetesjournals.org)
  • Another risk factor for NAFLD is chronic hepatitis C virus infection (HCV). (townsendletter.com)
  • 13 Weight loss and exercise, the only approved treatment strategies for NAFLD, are specifically relevant in the above risk groups, particularly if standard treatment is suggested. (townsendletter.com)
  • serum
  • Recently, it has been suggested that NAFLD is more common than originally expected, and that it may be present even when serum liver enzymes are not elevated ( 4 , 5 ). (pubmedcentralcanada.ca)
  • Incidence
  • The subjects were divided into 4 groups according to the baseline quartiles of fasting insulin, and the predictors of the incidence of MS were analyzed using multivariate regression analysis. (biomedcentral.com)
  • epidemiological
  • Epidemiological studies on NAFLD are limited by the lack of a universal screening method used for diagnosis and by the presence of various definitions and diagnostic criteria. (hindawi.com)
  • diagnosis
  • In the past, the diagnosis of NAFLD was mostly the result of ultrasound investigations or liver function tests performed at random. (hindawi.com)
  • Nowadays, the great attention paid to the occurrence of metabolic syndrome and its related aspects has allowed us to put more emphasis on diagnosis and treatment of this disorder. (hindawi.com)