Aim: 

The epidemic of obesity in all Western Countries is accompanied by the increase in the prevalence of non-alcoholic fatty liver disease. The aim of the present study was to investigate the relationships between diet, insulin resistance and fatty liver in obese people.

Methods: 

77 patients (35 males, median age 39 years, range 15-77) attending the Outpatient Clinics of Neuroscience Department were studied. Nutritional status was determined according to standard protocols. Liver ultrasound imaging, clinical biochemical tests and bioimpedance analysis were carried out. Insulin resistance was assessed by HOMA-R. The patients were classified in 4 groups according to BMI: overweight (25<30 kg/m2), obese I (30<35 kg/m2), obese II (35<40 kg/m2), obese III (>40 kg/m2).

Results: 

The increase in BMI from the first (27,6 ± 1,5 kg/mq) to the last group (45,7 ± 4,1 kg/mq) of patients corresponded to an increase in daily energy intake, accompanied by enhanced insulin resistance (HOMA-R 2,7 ± 1,8 and 7,6 ± 4,2, respectively). BMI and HOMA-R were highly correlated (r = 0.633, p< 0.01). Body fat mass was significantly correlated to severity of steatosis, shown by the serum levels of transaminases (ALT, r = 0.402; p< 0.05).

Conclusions: 

These results suggest that the increase in body fat mass facilitates the development and progression of fatty liver disease. Changes in diet and lifestyle may be the goal of fatty liver therapy, because weight loss could reduce hepatic steatosis and the resulting inflammation.