Non-Alkolik Steatoz Hastalarında Karaciğer Enzim Düzeylerinin ve İnsülin Direncinin Korelasyonu

Year 2019, Volume: 19 Issue: 1, 123 - 132, 22.03.2019

Demet Cekdemir , Mehmet Gunduz Arzu Celebi Hale Aslantas Gokhan Pekındıl Semin Ayhan Ender Ellidokuz

https://doi.org/10.17098/amj.542200

Abstract

Amaç: Non-alkolik basit hepatik steatoz
hastalarını karaciğer enzim düzeylerine göre karşılaştırmak ve glikoz
metabolizması ve insülin direncinin karaciğer enzim düzeyleri ile farklılık
gösterip göstermediğini saptamak.

Materyal ve Metot: Çalışmaya 18-65 yaş
arası non-alkolik basit hepatik steatozu olan hastalar dahil edildi. Hastalar
normal karaciğer enzimleri (NKE) ve artmış karaciğer enzimleri (AKE) olan
hastalar olarak iki gruba ayrıldı. Gruplar, glukoz metabolizması parametreleri
ve insülin direnci açısından karşılaştırıldı.

Bulgular: Çalışmamıza toplam 66
steatotik hasta (40 NKE ve 26 AKE) dahil edildi. NKE ve AKE gruplarında ortalama
insülin değerleri sırasıyla 12,92 ± 5,61 ve 16,22 ± 5,43 μU / mL idi (p =
0,012). NKE'deki 23 (%60,50) hastada ve steatotik AKE grubunda 22 hastada (%88)
insülin direnci saptandı (p = 0,018). NKE'de 31 (%77,50) hastada ve AKE
grubunda 15 hastada (%57,70) metabolik sendrom saptandı (p = 0,058).

Sonuç: Sonuç olarak, AKE'li steatotik grubun
insülin direncinin daha yüksek olduğu sonucuna vardık. Bu hastalar özellikle
insülin direncini azaltacak hem kilo kaybını artıracak hem de insülin direncine
duyarlı olacak ilaç tedavileri konusunda titiz bir şekilde dikkate alınmalıdır.
Karaciğer biyopsisi, kesin ayırıcı tanıda gerekli yerini hala korumaktadır.

Keywords

Non-alkolik basit hepatik steatoz, basit hepatik steatoz, insülin direnci

Correlation of Liver Enzyme Levels and Insulin Resistance in Patients with Non-Alcoholic Steatosis

Abstract

Objectives: To compare non-alcoholic steatosis patients according to liver enzyme
levels, and to establish whether glucose metabolism and insulin resistance
differ with liver enzyme levels.

Materials and Methods: Patients with
non-alcoholic steatosis aged between 18-65 years were included in this study.
The patients were divided into two groups as steatotic patients with normal
liver enzymes (NLE), and those with increased liver enzymes (ILE). The groups
were compared as for parameters of glucose metabolism, and insulin resistance.

Results: A total of 66 steatotic
patients (40 NLE, and 26 ILE) were included in our study. Mean insulin values
in the steatotic NLE, and ILE groups were 12.92±5.61, and 16.22±5.43 μU/mL
respectively (p=0.012). Insulin resistance was detected in 23 (60.50%) patients
in the steatotic NLE, and in 22 (88%) patients in the steatotic ILE groups
(p=0.018). Metabolic syndrome was detected in 31 (77.50%) patients in the
steatotic NLE, and in 15 (57.70%) patients in the steatotic ILE groups
(p=0.058).

Conclusion: In conclusion, we have
concluded that the steatotic group with ILE had higher insulin resistance. These
patients should be meticulously taken into consideration as for drug treatments
which will especially decrease insulin resistance, increase both weight loss,
and sensitivity to insulin resistance. Liver biopsy still retains its essential
place in definitive differential diagnosis.

Keywords

Non-alcoholic fatty liver disease, fatty liver, insulin resistance

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