caa a22 4500 445794860 CHVBK 20180317145121.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1807-7 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1807-7 Nonalcoholic Fatty Liver Disease Markers Are Associated with Insulin Resistance in Type 1 Diabetes [Elektronische Daten] [Tomislav Bulum, Branko Kolarić, Lea Duvnjak, Marko Duvnjak] Background: Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin resistance. Aims: To explore the relationship between markers of NAFLD, namely concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK), γ-glutamyltransferase (GGT), ferritin and bilirubin and insulin resistance in type 1 diabetes. Methods: Our study included 353 patients with type 1 diabetes. Insulin sensitivity was measured with estimated glucose disposal rate calculated using the equation: eGDR=24.31−(12.22×WHR)−(3.29×HT)−(0.57×HbA1c); WHR=waist to hip ratio, HT=hypertension. Correlations and multiple logistic regressions analysis were performed to identify the relationships between NAFLD associated markers and eGDR, individual components of insulin resistance and risk of insulin resistance. Results: AST, ALT, AST-to-ALT ratio, ALK and ferritin significantly correlated with insulin resistance measured by eGDR (r=−0.13, −0.14, 0.13, −0.18, and −0.24, respectively; all P<0.05), and with individual components of insulin resistance, most notably WHR. In a multiple logistic regression model adjusted according to age, sex, duration of diabetes and BMI, increased levels of AST, ALT and ALK resulted in an increased risk for the development of insulin resistance in our subjects (OR=1.03, 1.02, and 1.01, respectively; all P<0.05). Conclusions: These findings indicate that higher levels of ALT, AST and ALK are additional markers of insulin resistance in type 1 diabetes and suggest that those subjects must be considered as potentially affected not only by a hepatic but also by a multisystemic disease through altered insulin sensitivity. Springer Science+Business Media, LLC, 2011 Nonalcoholic fatty liver disease nationallicence Liver enzymes nationallicence Type 1 diabetes nationallicence Insulin resistance nationallicence Estimated glucose disposal rate nationallicence Bulum Tomislav Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia aut Kolarić Branko Medical School, University of Rijeka, Rijeka, Croatia aut Duvnjak Lea Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia aut Duvnjak Marko Medical School, University of Zagreb, Zagreb, Croatia aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3655-3663 0163-2116 56:12<3655 2011 56 10620 https://doi.org/10.1007/s10620-011-1807-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1807-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bulum Tomislav Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia aut NATIONALLICENCE 700 1- Kolarić Branko Medical School, University of Rijeka, Rijeka, Croatia aut NATIONALLICENCE 700 1- Duvnjak Lea Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia aut NATIONALLICENCE 700 1- Duvnjak Marko Medical School, University of Zagreb, Zagreb, Croatia aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3655-3663 0163-2116 56:12<3655 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer