ABSTRACT
Background: Nonalcoholic fatty liver disease [NAFLD] is a term with a wide spectrum of disorders ranging from simple steatosis to progressive nonalcoholic steatohepatitis [NASH], cirrhosis and hepatocellular carcinoma. Serum alanine aminotransferase [ALT] level is a well-recognized clinical marker of liver injury and may represent a consequence of the proinflammatory process accused in the pathogenesis of NAFLD. Insulin resistance seems to predispose lipid accumulation within the liver and progress to fibrosis in NAFLD
Aim of the study: to investigate the association of insulin resistance with ALT activity in NAFLD patients
Patients and Methods: 50 patients with NAFLD, diagnosed by abdominal ultrasonography, were included in this study. Full history, clinical evaluation, body mass index [BMI], waist circumference and laboratory tests including liver function tests, lipid profile, random blood glucose [RBG] and glycated Hemoglobin [HBA1c] were done. Also, fasting blood glucose and fasting insulin levels were determined for calculation of Homeostasis Model Assessment-Insulin Resistance [HOMA-IR]
Results: Patients were divided into two groups; group I included 28 patients with elevated serum ALT level and group II included 22 patients with normal serum ALT level. There was significant difference between the two groups as regard to prevalence of type 2 diabetes mellitus, elevated RBG level, HbAlc, HOMA-IR and waist circumference but no significant difference between the two groups regarding age, sex, BMI, lipid profile and incidence of hypertension and ischemic heart disease
Conclusion: Our findings suggested that increased ALT activity was associated with insulin resistance in patients with NAFLD