Nonalcoholic fatty liver disease (NAFLD) is linked with more severe hyperinsulinemia, dyslipidemia, and adipose tissue/hepatic insulin resistance in patients with type 2 diabetes, according to a study involving 154 obese individuals.

Investigators divided participants into 4 groups: control, diabetes without NAFLD, diabetes with isolated steatosis, and diabetes with nonalcoholic steatohepatitis (NASH). They evaluated intrahepatic triglycerides and assessed insulin secretion/resistance.

Among the results:

• There were no significant differences in sex, BMI, or total body fat.

• Diabetes and development of hepatic steatosis increasingly worsened metabolic parameters, with worse hyperinsulinemia, insulin resistance, and dyslipidemia in those with NASH.

• NASH was linked with more dysfunctional and insulin-resistant adipose tissue than was isolated steatosis.

• Insulin suppression of plasma free fatty acids was linked with hepatic steatosis and severity of steatohepatitis.

• Hepatic insulin sensitivity was also more significantly diminished in people with diabetes and NASH vs those in the other groups.

Citation: Lomonaco R, Bril F, Portillo-Sanchez P, et al. Metabolic impact of nonalcoholic steatohepatitis in obese patients with type 2 diabetes. [Published online ahead of print February 9, 2016]. Diabetes Care. doi:10.2337/dc15-1876.