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Leutner M, Göbl C, Schlager O, Charwat-Resl S, Wielandner A, Howorka E, Prünner M, Bozkurt L, Maruszczak K, Geyik H, Prosch H, Pacini G, Kautzky-Willer A. The Fatty Liver Index (FLI) Relates to Diabetes-Specific Parameters and an Adverse Lipid Profile in a Cohort of Nondiabetic, Dyslipidemic Patients. J Am Coll Nutr 2017; 36:287-294. [PMID: 28506114 DOI: 10.1080/07315724.2016.1262802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with hyperlipidemia are at high risk for developing a fatty liver. The fatty liver index (FLI) is a noninvasive and well-established method for the estimation of a fatty liver. However, little is known about the metabolic characterization of nondiabetic treated patients with hyperlipidemia who have different risk levels for a fatty liver. METHODS In this study, 74 nondiabetic patients with hyperlipidemia were divided into 3 groups according to their fatty liver index. A comparison of metabolic characteristics was done. These characteristics included intima media thickness (IMT) and nutritional habits, which were further divided into FLI subgroups with low, intermediate, and high risk for a fatty liver. RESULTS Patients with hyperlipidemia, with a high risk for a fatty liver (FLI ≥ 60), had subclinical elevations in parameters of carbohydrate metabolism (insulin, fasting plasma glucose, C-peptide) including a higher insulin resistance (quantitative insulin sensitivity check index, QUICKI) compared to lower FLI groups. These patients also presented a higher risk for a metabolic syndrome (p = 0.018), as well as an adverse lipid profile (e.g., high-density lipoprotein [HDL] cholesterol, triglycerides [TG]-HDL ratio). FLI group 3 was characterized by significantly lower levels of omega-3 fatty acids (p = 0.048). CONCLUSION The fatty liver index relates to diabetes-specific parameters and an adverse lipid profile and is an appropriate index for risk evaluation of metabolic syndrome.
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Affiliation(s)
- Michael Leutner
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Christian Göbl
- b Department of Gynecology and Obstetrics , Division of Obstetrics and Feto-Maternal Medicine.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Oliver Schlager
- c Department of Internal Medicine II , Division of Angiology.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Silvia Charwat-Resl
- c Department of Internal Medicine II , Division of Angiology.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Alice Wielandner
- d Department of Biomedical Imaging and Image Guided Therapy.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Eleonora Howorka
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Marlies Prünner
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Latife Bozkurt
- e Department of Internal Medicine III , Clinical Division of Endocrinology and Metabolism.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Katharina Maruszczak
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Hacer Geyik
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Helmut Prosch
- d Department of Biomedical Imaging and Image Guided Therapy.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Giovanni Pacini
- f Medical University of Vienna , Vienna , Austria.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
| | - Alexandra Kautzky-Willer
- a Department of Internal Medicine III, Division of Endocrinology and Metabolism , Gender Medicine Unit.,g Metabolic Unit, Institute of Neuroscience , National Research Council , Padova , Italy
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Leutner M, Göbl C, Wielandner A, Howorka E, Prünner M, Bozkurt L, Schlager O, Charwat-Resl S, Kautzky-Willer A. Clinical and metabolic characteristics of treated hyperlipidemic patients additionally affected by subclinical hyperglycemia. Lipids Health Dis 2016; 15:10. [PMID: 26762550 PMCID: PMC4712513 DOI: 10.1186/s12944-016-0180-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 01/08/2016] [Indexed: 01/24/2023] Open
Abstract
Background Impaired glucose regulation (IGR) and hyperlipidemia (HL) are associated with an increased risk of developing a cardiovascular disease. Hyperlipidemic patients were shown to bear a greater risk for an increased intima media thickness (IMT). However little is known about differences between treated hyperlipidemic patients (HL) with normal (NGR) or impaired (IGR) glucose regulation. Methods We performed a cross-sectional study, involving 96 non-diabetic HL patients with IGR (fasting plasma glucose of ≥ 100 mg/dl and <126 mg/dl or/and HbA1c-level of ≥ 5.7 and <6.5 %) or with NGR (HbA1c-level of <5.7 % and a fasting glucose <100 mg/dl). We compared metabolic characteristics and the IMT between the two groups. Insulin sensitivity in fasting conditions was described by HOMA-IR and QUICKI. Results HL-IGR patients were older (57.6 ± 10.4 vs. 49.1 ± 8.7, p < 0.001), had higher carotid IMT measurements (IMT average: 0.68 ± 0.14 vs. 0.60 ± 0.09, p = 0.002; IMT right: 0.67 ± 0.15 vs. 0.60 ± 0.10, p = 0.013; IMT left: 0.63 vs. 0.57, p = 0.009), as well as a higher chance to exceed a cut-off value of ≥0.8 mm or insignificant stenosis within this investigation (OR: 3.9, 95 % CI: 1.15-13.22, p = 0.029) compared to HL-NGR-patients. Furthermore HL-IGR patients were characterised by a higher waist circumference (100.6 ± 10.1 vs. 91.6 ± 13.3, p < 0.001), higher fasting plasma glucose-levels (100.1 ± 10.8 vs. 88.1 ± 6.6, p < 0.001), higher HbA1c concentrations (5.8 ± 0.33 vs. 5.3 ± 0.24, p < 0.001) and C-peptide levels (2.70 vs. 2.10, p = 0.012). Age and CVD status were in general the only two variables which independently explained IMT. Conclusion Our study showed that among patients with treated hyperlipidemia the presence of IGR characterised subjects who were older and had a significantly higher risk for an increased IMT compared with those maintaining NGR. Further studies are necessary to evaluate if this specific subpopulation with IGR can benefit from a more strict multifactorial management and perhaps from an additional early antihyperglycaemic treatment.
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Affiliation(s)
- Michael Leutner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Christian Göbl
- Department of Gynecology and Obstetrics, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Alice Wielandner
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Eleonora Howorka
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Marlies Prünner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Latife Bozkurt
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Oliver Schlager
- Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Silvia Charwat-Resl
- Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
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Leutner M, Göbl C, Wielandner A, Howorka E, Prünner M, Bozkurt L, Harreiter J, Prosch H, Schlager O, Charwat-Resl S, Kautzky-Willer A. Cardiometabolic Risk in Hyperlipidemic Men and Women. Int J Endocrinol 2016; 2016:2647865. [PMID: 27895666 PMCID: PMC5118507 DOI: 10.1155/2016/2647865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 10/04/2016] [Accepted: 10/09/2016] [Indexed: 12/30/2022] Open
Abstract
Objective. The aim of this study was to evaluate sex specific differences of metabolic and clinical characteristics of treated hyperlipidemic men and women (HL-men and HL-women). Methods. In this study vascular and metabolic characteristics of 35 HL-women and 64 HL-men were assessed. In addition a sex specific analysis of metabolic and nutritional habits of HL-patients with prediabetes (HL-IGR) was done. Results. HL-women were older and had favourable concentrations of high density lipoprotein cholesterol (HDL-cholesterol), triglycerides (TG), and triglyceride/HDL-cholesterol ratio (TG/HDL-ratio) but were also shown to have higher concentrations of lipoprotein-a compared to HL-men. HL-men were characterized as having higher levels of liver-specific parameters and body weight as well as being more physically active compared to HL-women. Brain natriuretic peptide (pro-BNP) was higher in HL-women than HL-men, while no differences in metabolic syndrome and glycemic parameters were shown. HL-IGR-women were also older and still had a better profile of sex specific lipid parameters, as well as a lower body weight compared to HL-IGR-men. No differences were seen in vascular parameters such as the intima media thickness (IMT). Conclusion. HL-women were older and had overall more favourable concentrations of lipid parameters and liver enzymes but did not differ regarding vascular morphology and insulin sensitivity compared to HL-men of comparable body mass index (BMI).
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Affiliation(s)
- Michael Leutner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Christian Göbl
- Department of Gynecology and Obstetrics, Division of Feto-Maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Alice Wielandner
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Eleonora Howorka
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Marlies Prünner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Latife Bozkurt
- Department of Internal Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Waehringer Giertel 18-20, 1090 Vienna, Austria
| | - Jürgen Harreiter
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Helmut Prosch
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Oliver Schlager
- Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Silvia Charwat-Resl
- Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
- *Alexandra Kautzky-Willer:
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