John Jeffrey Carr
Professor of Radiology, Biomedical Informatics and Cardiovascular Medicine
Last active: 1/10/2020

Insulin Resistance Exacerbates Genetic Predisposition to Nonalcoholic Fatty Liver Disease in Individuals Without Diabetes.

Barata L, Feitosa MF, Bielak LF, Halligan B, Baldridge AS, Guo X, Yerges-Armstrong LM, Smith AV, Yao J, Palmer ND, VanWagner LB, Carr JJ, Chen YI, Allison M, Budoff MJ, Handelman SK, Kardia SLR, Mosley TH, Ryan K, Harris TB, Launer LJ, Gudnason V, Rotter JI, Fornage M, Rasmussen-Torvik LJ, Borecki IB, O'Connell JR, Peyser PA, Speliotes EK, Province MA
Hepatol Commun. 2019 3 (7): 894-907

PMID: 31334442 · PMCID: PMC6601321 · DOI:10.1002/hep4.1353

The accumulation of excess fat in the liver (hepatic steatosis) in the absence of heavy alcohol consumption causes nonalcoholic fatty liver disease (NAFLD), which has become a global epidemic. Identifying metabolic risk factors that interact with the genetic risk of NAFLD is important for reducing disease burden. We tested whether serum glucose, insulin, insulin resistance, triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, body mass index (BMI), and waist-to-hip ratio adjusted for BMI interact with genetic variants in or near the patatin-like phospholipase domain containing 3 () gene, the glucokinase regulatory protein () gene, the neurocan/transmembrane 6 superfamily member 2 () gene and the lysophospholipase-like 1 () gene to exacerbate hepatic steatosis, estimated by liver attenuation. We performed association analyses in 10 population-based cohorts separately and then meta-analyzed results in up to 14,751 individuals (11,870 of European ancestry and 2,881 of African ancestry). We found that rs738409 significantly interacted with insulin, insulin resistance, BMI, glucose, and TG to increase hepatic steatosis in nondiabetic individuals carrying the G allele. Additionally, rs780094 significantly interacted with insulin, insulin resistance, and TG. Conditional analyses using the two largest European ancestry cohorts in the study showed that insulin levels accounted for most of the interaction of rs738409 with BMI, glucose, and TG in nondiabetic individuals. Insulin, -rs738409, and their interaction accounted for at least 8% of the variance in hepatic steatosis in these two cohorts. Insulin resistance, either directly or through the resultant elevated insulin levels, more than other metabolic traits, appears to amplify the -rs738409-G genetic risk for hepatic steatosis. Improving insulin resistance in nondiabetic individuals carrying rs738409-G may preferentially decrease hepatic steatosis.

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