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Issue 219 Item15

Fatty Liver in Hypertensives Tied to Insulin Resistance
Issue 219 Item15

Fatty liver disease without elevated liver enzymes occurs significantly more often in people with arterial hypertension than in the general population and appears to be related to insulin resistance. The clinical meaning of fatty liver with normal liver enzymes is still largely unknown. Dr. Piscaglia from the University of Bologna and colleagues report that fatty liver, as detected by abdominal ultrasound, with normal liver enzymes is a relatively common in arterial hypertensive patients.

The researchers found that in 55 non-obese, non-diabetic, non-alcoholic, hepatitis-negative patients with arterial hypertension, the prevalence of fatty liver with normal enzymes was 30.9% versus 12.7% in 55 sex- and age- matched healthy controls.

The presence of this condition appeared independently associated with increased insulin resistance (odds ratio, 1.66) and body mass index (odds ratio, 1.22).

"Since insulin resistance is an important prognostic factor in hypertensive subjects, fatty liver might be a candidate in identifying patients bearing a higher cardiovascular risk," Dr. Piscaglia added.

In an accompanying editorial, Dr. A. M. Diehl from Johns Hopkins University, Baltimore, Maryland, comments that these results "are important because they complement and extend other evidence that correlates hepatic steatosis with insulin resistance." The strong tie between these two conditions, he points out, has "tremendous clinical relevance." Gut 2004;53:923-924,1020-1023