WESTPORT, CT (Reuters Health) – The clinical features of insulin resistance syndrome are common among patients with nonalcoholic steatohepatitis (NASH), suggesting that NASH may be the hepatic manifestation of this disorder.
To better understand NASH and its relationship to insulin resistance syndrome, Dr. Ira R. Willner, from the Medical University of South Carolina in Charleston, and colleagues reviewed the medical records of 90 patients with NASH.
Contrary to reports that NASH is a disease of middle-aged females, men and women were equally affected and patients ranged from 14 to 70 years of age. All but 12 patients were obese and 16 patients came from 9 families with a history of NASH.
While NASH is often thought to have a benign course, 25 patients in the current study developed cirrhosis. Cirrhosis was more common in patients who were morbidly obese. Furthermore, 11 cirrhotic patients had complications of portal hypertension and 7 of these patients were awaiting or had undergone liver transplantation.
Almost all patients had diabetes or evidence of insulin resistance, the authors note in the October issue of The American Journal of Gastroenterology. Other components of the insulin resistance syndrome, such as hyperlipidemia, hypertension, and atherosclerotic disease, were also common in this study population.
"In many patients, NASH may be the hepatic manifestation of the insulin resistance syndrome," the researchers suggest. "Like hypertension, hyperlipidemia, atherosclerosis, and diabetes, NASH results from the underlying defect, either the hyperinsulinemia itself or some undefined defect, most probably inherited, which results in all of these clinical manifestations."
Am J Gastroenterol 2001;96:2957-2961.
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