Metabolic Syndrome Research Paper
2.4 NAFLD and the metabolic syndrome
The metabolic syndrome is a constellation of closely related cardiovascular risk factors. The International Diabetes Federation defines metabolic syndrome as the presence of central obesity based on ethnic specific cut-off for waist circumference, plus two or more of the following: raised triglycerides, reduced serum high-density lipoprotein (HDL) cholesterol, raised blood pressure and raised fasting plasma glucose.(42)
Insulin resistance is an important feature of metabolic syndrome. As elucidated in the earlier section, insulin resistance also serves as the first of the two hits in the pathogenesis of
NAFLD. Hence, NAFLD is closely related to the metabolic syndrome. In fact, NAFLD has been considered as the liver manifestation of the metabolic syndrome.(43) The prevalence of NAFLD is high in those with metabolic syndrome and the
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Insulin resistance is not considered disease as such, but a state or condition in which a bodies tissues have a lowered level of response to insulin. As a result, the body produces larger quantities of insulin to maintain normal levels of glucose in the blood.(22)
Now insulin resistance is thought to play a pivotal role in the pathophysiology of both simple fatty liver and NASH. The understanding of the intracellular mechanisms associated with insulin resistance is being unravelled and there are several reviews written on this subject. (45)
Although lean persons can be insulin resistant, it is most commonly found in overweight or obese individuals. However, the degree of insulin resistance varies considerably amongst equally obese subjects.(46) In normal weight and moderately overweight subjects, fat accumulation within the liver was associated with several features of insulin resistance, independently of body mass index and intra abdominal and overall
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