Demet Cekdemir, Mehmet GUNDUZ, Arzu CELEBİ, Hale Aslantas, Gokhan PEKINDIL, Semin Ayhan, Ender Ellidokuz

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

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.

Anahtar Kelimeler:

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

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

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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