Clinical–Liver, Pancreas, and Biliary TractIncreased Liver Fat, Impaired Insulin Clearance, and Hepatic and Adipose Tissue Insulin Resistance in Type 2 Diabetes
Section snippets
Subjects
The nondiabetic subjects and the type 2 diabetic patients were recruited by newspaper advertisements and by contacting occupational health services in Helsinki based on the following inclusion criteria: (1) age 18–70 years; (2) no known acute or chronic disease, other than obesity, hypertension, or type 2 diabetes, based on history, physical examination, and standard laboratory tests; and (3) alcohol consumption <20 g/day. Exclusion criteria were evidence of any other disease, treatment with
Subject Characteristics (Table 1)
The nondiabetic subjects and type 2 diabetic patients were comparable with respect to age, gender, BMI, percent whole body fat, blood pressure, S-liver enzyme, and LDL cholesterol concentrations. Fasting plasma glucose, HbA1c, and fS-triglycerides were higher, and fS-HDL cholesterol lower in the type 2 diabetic patients than the nondiabetic subjects. Intraabdominal fat was 44%, and liver fat 54%, higher in the type 2 diabetic patients than in the nondiabetic subjects.
Serum Insulin Concentrations in the Basal State and During Insulin Infusion (Table 2)
FS-insulin concentrations
Discussion
In the present study, we cross-sectionally examined whether insulin clearance is impaired in type 2 diabetic patients, and how it relates to liver fat and hepatic, peripheral, and adipose tissue insulin sensitivity in a relatively large number of type 2 diabetic patients and age-, gender-, and BMI-matched nondiabetic subjects. Liver fat content was 54% higher and insulin clearance 24% lower in the type 2 diabetic patients than the nondiabetic subjects. The decrease in insulin clearance resulted
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Supported by research grants from the Academy of Finland, the Sigrid Juselius Foundation, and Novo Nordisk Foundation. This work is part of the project “Hepatic and adipose tissue and functions in the metabolic syndrome” (www.hepadip.org), which is supported by the European Commission as an Integrated Project under the 6th Framework Programme (Contract LSHM-CT-2005-018734).