Whole-body substrate metabolism is associated with disease severity in patients with non-alcoholic fatty liver disease

摘要: Objectives In non-alcoholic fatty liver disease (NAFLD), hepatic steatosis is intricately linked with a number of metabolic alterations. We studied substrate utilisation in NAFLD during basal, insulin-stimulated and exercise conditions, correlated these outcomes severity. Methods 20 patients (mean±SD body mass index (BMI) 34.1±6.7 kg/m 2 ) 15 healthy controls (BMI 23.4±2.7 kg/m were assessed. Respiratory quotient (RQ), whole-body fat (Fat ox carbohydrate (CHO oxidation rates determined by indirect calorimetry three conditions: basal (resting fasted), (hyperinsulinaemic–euglycaemic clamp) (cycling at an intensity to elicit maximal Fat ). Severity histology, from plasma β-hydroxybutyrate concentrations, aerobic fitness expressed as , visceral adipose tissue (VAT) measured computed tomography. Results Within the overweight/obese cohort, RQ positively (r=0.57, p=0.01) was higher (indicating smaller contribution energy expenditure) activity score (NAS) ≥5 vs (1.2±0.3 1.5±0.4 mg/kgFFM/min, p=0.024) lower (ie, β-hydroxybutyrate, p=0.004). During exercise, they achieved (2.5±1.4 vs. 5.8±3.7 p=0.002) (p not associated severity (p=0.79). Conclusions Overweight/obese had reduced under conditions. There inverse relationship between ability oxidise conditions histological features including NAS.