Potential Usefulness of Intrahepatic Lipid Accumulation and Liver Function Tests to Identify Insulin Resistance Phenotype in Non-Obese Type 2 Diabetes

Abstract

Despite low body mass index (BMI), Asian people often develop type 2 diabetes 1)-3). In addition to reduced insulin secretion, etiological difference of insulin resistance (IR) between Caucasian and Asian might be involved in this phenomenon 4) 5). Previous data demonstrated that non-obese Asians easily develop non-alcoholic fatty liver disease (NAFLD) 6)-8) which is considered as cause and result of IR 9)-14). As well as fat accumulation in liver, liver enzymes, such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), are easily elevated by small increase in BMI within normal limits in Asians 15); however those are less observed in other ethnicities 16). In addition, both ALT and GGT were correlated to insulin resistance independent of measures of adiposity 17) 18). These data suggested that intrahepatic lipid (IHL) accumulation and liver dysfunction could be markers of IR in non-obese type 2 diabetes.