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Frequency and predictors of nonalcoholic fatty liver disease in myotonic dystrophy.
Muscle Nerve 2010; 41(2):197-201MN

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease that is strongly associated with insulin resistance. Myotonic dystrophy (DM1) is the most common form of adult-onset muscular dystrophy, and there is a high frequency of insulin resistance due to insulin receptor mRNA splicing defects in muscle tissue. The frequency and predictors of NAFLD in this population have not been described. Thirty-six patients with DM1 were prospectively assessed for the presence of NAFLD and insulin resistance. NAFLD was defined by abnormal liver chemistry tests with ultrasound or pathologic evidence of steatosis in the absence of other liver disease. Abnormal liver chemistry tests were found in 44% of DM1 patients (mean ALT 73 +/- 21 U/L, AST 53 +/- 15 U/L), and 87% were attributable to NAFLD. Clinical predictors of NAFLD included increased insulin resistance by the homeostasis model assessment (HOMA) method (9.5 vs. 4.0 U, P = 0.03), elevated fasting insulin (40.4 vs. 16.1 microIU/ml, P = 0.03), abdominal obesity (98.6 vs. 90.8 cm, P = 0.03), elevated triglycerides (195.7 vs. 136.8 mg/dl, P = 0.02), and elevated total cholesterol (213.6 vs. 180.6 mg/dl, P = 0.02). NAFLD is very common and should be considered in the management of DM1. It is strongly associated with markers of insulin resistance and features of the metabolic syndrome. These findings support the role of peripheral insulin resistance in the pathogenesis of NAFLD.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 110 Lockwood Street, Suite 116, Providence, Rhode Island 02903, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19813185

Citation

Shieh, Kenneth, et al. "Frequency and Predictors of Nonalcoholic Fatty Liver Disease in Myotonic Dystrophy." Muscle & Nerve, vol. 41, no. 2, 2010, pp. 197-201.
Shieh K, Gilchrist JM, Promrat K. Frequency and predictors of nonalcoholic fatty liver disease in myotonic dystrophy. Muscle Nerve. 2010;41(2):197-201.
Shieh, K., Gilchrist, J. M., & Promrat, K. (2010). Frequency and predictors of nonalcoholic fatty liver disease in myotonic dystrophy. Muscle & Nerve, 41(2), pp. 197-201. doi:10.1002/mus.21484.
Shieh K, Gilchrist JM, Promrat K. Frequency and Predictors of Nonalcoholic Fatty Liver Disease in Myotonic Dystrophy. Muscle Nerve. 2010;41(2):197-201. PubMed PMID: 19813185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequency and predictors of nonalcoholic fatty liver disease in myotonic dystrophy. AU - Shieh,Kenneth, AU - Gilchrist,James M, AU - Promrat,Kittichai, PY - 2009/10/9/entrez PY - 2009/10/9/pubmed PY - 2010/2/18/medline SP - 197 EP - 201 JF - Muscle & nerve JO - Muscle Nerve VL - 41 IS - 2 N2 - Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease that is strongly associated with insulin resistance. Myotonic dystrophy (DM1) is the most common form of adult-onset muscular dystrophy, and there is a high frequency of insulin resistance due to insulin receptor mRNA splicing defects in muscle tissue. The frequency and predictors of NAFLD in this population have not been described. Thirty-six patients with DM1 were prospectively assessed for the presence of NAFLD and insulin resistance. NAFLD was defined by abnormal liver chemistry tests with ultrasound or pathologic evidence of steatosis in the absence of other liver disease. Abnormal liver chemistry tests were found in 44% of DM1 patients (mean ALT 73 +/- 21 U/L, AST 53 +/- 15 U/L), and 87% were attributable to NAFLD. Clinical predictors of NAFLD included increased insulin resistance by the homeostasis model assessment (HOMA) method (9.5 vs. 4.0 U, P = 0.03), elevated fasting insulin (40.4 vs. 16.1 microIU/ml, P = 0.03), abdominal obesity (98.6 vs. 90.8 cm, P = 0.03), elevated triglycerides (195.7 vs. 136.8 mg/dl, P = 0.02), and elevated total cholesterol (213.6 vs. 180.6 mg/dl, P = 0.02). NAFLD is very common and should be considered in the management of DM1. It is strongly associated with markers of insulin resistance and features of the metabolic syndrome. These findings support the role of peripheral insulin resistance in the pathogenesis of NAFLD. SN - 1097-4598 UR - https://www.unboundmedicine.com/medline/citation/19813185/Frequency_and_predictors_of_nonalcoholic_fatty_liver_disease_in_myotonic_dystrophy_ L2 - https://doi.org/10.1002/mus.21484 DB - PRIME DP - Unbound Medicine ER -