Hepatic lipase activity is increased in non- alcoholic fatty liver disease beyond insulin resistance

MIKSZTOWICZ V ; LUCERO D; ZAGO V; CACCIAGIÚ L; LOPEZ G; GONZALEZ BALLERGA E; SORDÁ J; FASSIO E; SCHREIER L; BERG G

DIABETES/METABOLISM RESEARCH AND REVIEWS.

JOHN WILEY & SONS LTD

Lugar: Londres; Año: 2012 vol. 28 p. 535 - 541

1520-7552

Background and objective Hepatic lipase is a lipolytic enzymemostly synthesized and localized at the surface of liver sinusoidal capillaries, which hydrolyses triglycerides and phospholipids of intermediate density, large low density (LDL) and high density lipoproteins. Hepatic lipase activity is increased in insulin resistant states. Non-alcoholic fatty liver disease (NAFLD) is characterized by insulin resistance; however, at present, no data are available regarding the behaviour of hepatic lipase in reference to hepatic steatosis degree. Our aimwas to evaluate hepatic lipase activity in NAFLD patients and its relationship with the different hepatic steatosis grade. Design and patients We studied 48 patients with NAFLD (diagnosed by ultrasonography and confirmed by liver biopsy) and 30 controls. Steatosis was semi quantitatively assessed and considered as mild or grade 1, moderate or grade 2 and severe or grade 3. Measurements: hepatic lipase activity, lipid and lipoprotein profile (including intermediate density lipoproteins and dense LDL), adiponectin, insulin, glucose and high sensitivity C-reactive protein were measured. Homeostasis model assessment for insulin resistance (HOMA) index was calculated. Results Patients with hepatic steatosis presented higher hepatic lipase activity, HOMA and dense LDL and lower levels of adiponectin, high density lipoproteins cholesterol and apoA-I. Hepatic lipase activity positively correlated and significantly with hepatic steatosis degree. Hepatic lipase correlated with a more atherogenic profile and persisted higher in patients even after corrected by age, gender, body mass index, HOMA and adiponectin. Conclusion The higher hepatic lipase activity in NAFLD patients contributes to a more atherogenic profile linked to increased cardiovascular risk, beyond the insulin resistance and the reduction in adiponectin.