Benedict, A.; Tang, S.; Joshi, D.; Panteli, J.; Brothers, S.; Crook, M.; O'Donohue, J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA102
Academic Journal
Introduction and Aims: Non-alcoholic steatohepatitis (NASH) has been associated with the insulin-resistant states. We aimed to investigate the prevalence of insulin resistant features in patients with both NASH and dyslipidaemia, to characterise changes over time in weight, liver biochemistry, serum lipids, and triglycerides, and to determine the effect of dietary advice. Methods: 39 patients with both NASH and dyslipidaemia were identified from the Lipid and Gastroenterology Databases (19962001). Alcoholic, viral, autoimmune, or other metabolic diagnoses excluded. Results: 21 patients were female. Mean age at fist visit was 52.3 years, weight 80.7 kg, BM129.03 kg/m²; 48% were overweight and a further 40% obese. 67.7% were hypertensive and 30.8% were diabetic, of whom 50% were on diet alone. 20.5% were taking statins, 12.8% fibrates, and 7.7% omega-3 oils. Mean follow up was 583 days (median 400 days). Mean weight decreased from 80.7 to 80.25 kg (p = NS), total cholesterol from 6.40 to 6.04 mmol/I (p = 0.053), triglycerides from 3.59 to 3.40 mmol/I (p = NS) and the ratio of total cholesterol to HDL decreased from 5.9 to 4.5 (p < 0.02) with a corresponding increase in mean HDL from 1.08 to 1.35 mmol/I (p < 0.018). Mean ALT decreased from 57.1 to 55.7 iu/I (p = NS), with weight change significantly associated with ALT change (R² = 0.056, p < 0.04). Patients referred for for weight and lipid lowering diets were significantly heavier at baseline (83.3 kg, n = 19) than those not referred (77.1 kg, n = 19, p < 0.01); neither group lost weight, but total cholesterol (by 0.31 mmol/I) and serum triglycerides (by 0.38 mmol/I) fell in the advice group only (excluding patients on lipid lowering agents) (p < 0.03). Conclusion: These patients with both NASH and dyslipidaemia also had a strikingly high prevalence of hypertension, obesity, and diabetes mellitus. Dietary advice produced no overall weight loss in the group but appeared to improve lipid profile. ALT...


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