[Glucose tolerance alterations and frequency of metabolic syndrome among patients with non alcoholic fatty liver disease].

BACKGROUND Non alcoholic fatty liver disease (NAFLD) is associated to diabetes mellitus, obesity, disturbances in serum lipid levels, insulin resistance and metabolic syndrome. AIM To assess glucose tolerance and the presence of metabolic syndrome among patients with biopsy proven NAFLD. PATIENTS AND METHODS Serum lipid levels, hepatic function tests were measured and an oral glucose tolerance test was performed in 46 patients (mean age 45+/-12 years, 36 females) without history of diabetes mellitus and with steatosis in a liver biopsy. RESULTS Mean body mass index of the sample was 37+/-12 kg/m2. Seventeen percent had pure steatosis, 78% had steatohepatitis with or without fibrosis and 50% had fibrosis in the liver biopsy. Glucose intolerance and diabetes was found in 57% and 15% of cases, respectively. The presence of steatohepatitis was higher in diabetics, compared with subjects with glucose intolerance or a normal glucose response (43, 38 and 8%, respectively, p < 0.0001). Ninety three percent had a metabolic syndrome and the proportion of biopsies with fibrosis was higher among subjects with more than three diagnostic criteria for metabolic syndrome compared with those with three or less criteria (59 and 46%, respectively, p < 0.05). CONCLUSIONS Glucose intolerance, diabetes and metabolic syndrome are common among patients with NAFLD, even when they are not obese.