Diabetes, Metabolic Syndrome and Obesity (Jun 2019)
Obesity, adipocyte hypertrophy, fasting glucose, and resistin are potential contributors to nonalcoholic fatty liver disease in South Asian women
Abstract
Kembra Albracht-Schulte,1 Shanthini Rosairo,2 Latha Ramalingam,1 Sulochana Wijetunge,3 RMCJ Ratnayake,4 HMSRB Kotakadeniya,5 John A Dawson,1 Nishan S Kalupahana,1,6 Naima Moustaid-Moussa11Department of Nutritional Sciences and Obesity Research Institute, Texas Tech University, Lubbock, TX, USA; 2Department of Radiology, University of Peradeniya, Peradeniya, Sri Lanka; 3Department of Pathology, University of Peradeniya, Peradeniya, Sri Lanka; 4Department of Obstetrics and Gynecology, University of Peradeniya, Peradeniya, Sri Lanka; 5Department of Surgery, University of Peradeniya, Peradeniya, Sri Lanka; 6Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri LankaPurpose: Nonalcoholic fatty liver disease (NAFLD) is often referred to as the hepatic manifestation of the metabolic syndrome. The relationship between body weight, NAFLD, and insulin resistance is not well characterized in humans. Additionally, it is unclear why South Asians develop these complications at lower levels of obesity compared to their Western counterparts.Patients and methods: To address this question, we performed a cross-sectional study using a convenience sample of Sri Lankan adult females (n=34) and collected anthropometric data, adipose tissue specimens (for histology), and fasted serum samples (for metabolic and inflammatory markers). Hepatic steatosis was assessed by ultrasound scanning and used to classify participants as NAFL 0, NAFL 1, and NAFL 2.Results: Waist circumference significantly increased with increasing NAFL grade. Participants with NAFL had significantly higher body mass index, hip circumference, and fasting plasma glucose, as well as a higher mean adipocyte area in both abdominal subcutaneous and visceral areas, indicating a higher degree of adipocyte hypertrophy associated with fatty liver. There were, however, no differences in measures of dyslipidemia. Of the multiple adipokines measured, resistin was the only proinflammatory adipokine significantly elevated in NAFL 2.Conclusion: These findings indicate that measures of adiposity, fasting serum glucose, and resistin may be important indicators of NAFLD in South Asian women.Keywords: adipokines, inflammation, metabolic syndrome