Abstract
Magnetic resonance spectroscopy (MRS) is a non-invasive method for quantitative estimation of liver fat. Knowledge of its imprecision, which comprises biological variability and measurement error, is required to design therapeutic trials with measurement of change. The role of adipocyte lipolysis in ectopic fat accumulation remains unclear. We examined the relationship between liver fat content and indices of lipolysis, and determine whether lipolysis reflects insulin resistance or metabolic liver disease. Imprecision of measurement of liver fat was estimated from duplicate measurements by MRS at one month intervals. Patients provided fasting blood samples and we examined the correlation of liver fat with indices of insulin resistance, lipolysis and metabolic liver disease using Kendall Tau statistics. The coefficient of variation of liver fat content was 14.8%. Liver fat was positively related to serum insulin (T = 0.48, p = 0.042), homeostasis model assessment (HOMA)-B% (T = −0.48, p = 0.042), and body mass index (BMI) (T = 0.59, p = 0.012); and inversely related to HOMA-S% (T = −0.48, p = 0.042), serum glycerol (T = −0.59, p = 0.014), and serum caeruloplasmin (T = 0.055, p = 0.047). Our estimate of total variability in liver fat content (14.8%) is nearly twice that of the reported procedural variability (8.5%). We found that liver fat content was significantly inversely related to serum glycerol but not to non-esterified fatty acids (NEFA), suggesting progressive suppression of lipolysis. Reduction of caeruloplasmin with increasing liver fat may be a consequence or a cause of hepatic steatosis.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is associated with the histological finding of hepatic steatosis or steatohepatitis and has a number of causes [1,2,3,4]
In this group of patients, we found no evidence of increased lipolysis despite increasing insulin resistance with increasing liver fat content
Higher liver fat content was significantly associated with lower serum glycerol but not non-esterified fatty acids (NEFA)
Summary
Nonalcoholic fatty liver disease (NAFLD) is associated with the histological finding of hepatic steatosis or steatohepatitis and has a number of causes [1,2,3,4]. Steatosis is defined as a liver fat content. 2016, 17, 1089 of greater than 5% [3,5], and may be detected by ultrasonography in patients investigated for abnormal saebrnuomrmtaral nsesarummintarsaensleavmeilns.asIet liesvaelcso. TAhlethcooungdhititohne cisonudsuitaiollny ibseunsiugnal,l1y0b%enoifgpn,a1ti0e%ntsofdpoaptireongtrsedsso tporongorneaslscotohonloicnasltceoahtoohliecpsatteiatitsoh(NepAaStiHti)s, o(Nf wAShHom), o2f5%whmoamy 2p5r%ocemeadytoprcoircreheodsitso[c2i]r.rhosis [2]. Magnetic resonance spectroscopy (MRS) is a non-invasive and effective method in assessment of hepatic fat accumulation with high diagnostic accuracy and correspondence with histopathologic grade bbeeininggdedmemonosntrsatrtaetded[6][.6I]m. PImrepcirseiocinsiionnthienmtheaesumreemaseunrteomfelinvteroffatlicvoenrtefnatt bcyoMntRenStcobmy pMrisReSs bcoiomlopgricsaesl vbaiorilaobgiilciatyl vaanrdiambileiatysuarnemd emnteaesrurorer.meItntiserarnori.mIpt oisrtaannt icmonpsoirdtaenratticoonnsiindetrhaetidonesignnthoef tdheesrigapneoufttichetraiaplesuatimc tirniaglstoaimmeinagsutroemcheasnugree icnhalinvgeer ifnatlicvoenrtfeanttc.onWtenets. Wheepiantvicestiegaatotesdist[h8e].reWlaetiionnvsehsitpigbaetetwd etehne lrievleartiofantsahnipd binedtwiceeesnolfivlieproflaytsiasnadndinmdiecetasbooflilcipliovlyersids iasneadsemaestatbhoelsiec hliavveer tdhiesepaoseteanstitahletsoeinhflavueenthce bpiootleongticaalltovairnifalbuielnitcye. biological variability
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