Abstract 9515: NMR Spectroscopy Uncovers Important Atherogenic Lipoprotein Abnormalities in Nonalcoholic Fatty Liver Disease: The Insulin Resistance Atherosclerosis Study (IRAS).

Abstract

Introduction: Nonalcoholic fatty liver disease may be the most frequent cause of chronically elevated transaminase levels in the general population. One of these inexpensive and routinely measured enzymes, alanine aminotransferase (ALT) is an independent predictor of future cardiovascular disease and diabetes. ALT has been associated with dyslipidemia, but the extent of this relationship is not well described. Hypothesis: Because to its advantage over conventional methods, we hypothesized that proton nuclear magnetic resonance (NMR) spectroscopy could be better for detecting atherogenic lipoprotein abnormalities in nonalcoholic fatty liver disease. Thus, we analyzed the relation of ALT to lipoproteins measured by NMR spectroscopy and conventional methods in non-diabetic participants in the IRAS. Methods: Cross-sectional analysis of lipoproteins and apolipoproteins in 912 non-diabetic participants in the IRAS. In fasting single fresh plasma samples, we measured plasma lipoproteins by conventional methods and NMR spectroscopy and apolipoprotein B (apo B) by immunoprecipitation. Insulin sensitivity was measured by the frequently sampled intravenous glucose tolerance test. Results: After adjusting for age, sex, race/ethnicity, and clinic, ALT was associated with triglycerides, LDL and HDL cholesterol, and apo B ( Table ). ALT had significant relationships with large VLDL, total LDL, IDL, small LDL, and large HDL particle concentrations plus VLDL, LDL, and HDL particle sizes. ALT remained associated with total LDL, IDL, and small LDL particle concentrations, LDL particle size, and apo B after the additional adjustment for waist circumference and insulin sensitivity. Conclusions: NMR spectroscopy uncovers a more extensive relationship between atherogenic lipoprotein abnormalities and ALT in non-diabetic individuals. These abnormalities could partially explain the relation of ALT to future cardiovascular disease.