Fertile females with nonalcoholic fatty liver disease (NAFLD) have higher levels of ALT than postmenopausal females: implications for the influence of fertility on NAFLD.

摘要

BACKGROUND/AIMS: Insulin resistance recently has been reported to play a major role in nonalcoholic fatty liver disease (NAFLD). We evaluated the influence of fertility on fatty liver injury in fertile and postmenopausal women with insulin resistance. METHODOLOGY: We investigated 152 patients with noninsulin-dependent diabetes mellitus without insulin treatment; 46 males, 52 fertile women and 54 postmenopausal women. All had liver damage and/or steatosis recognized by ultrasonography. We measured the fasting serum levels of C-peptide and insulin, as markers of insulin resistance, and the serum levels of ALT. The severity of liver steatosis was judged by ultrasonography. RESULTS: Fertile females had significantly higher levels of ALT and demonstrated a more significant correlation between serum levels of ALT and C-peptide or insulin than did the postmenopausal females or males. Fertile females with moderate to severe steatosis had significantly higher levels of ALT than those with mild or no steatosis, although such a significant difference was not found in postmenopausal females or males. CONCLUSIONS: We demonstrate that fertility is an important factor in fatty liver damage of NAFLD with insulin resistance, suggesting that estrogen may exacerbate nonalcoholic steatohepatitis.