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Internal and Emergency Medicine

Erschienen in:

16.11.2019 | CE-Research Letter to the Editor

Liver alterations in anorexia nervosa are not caused by insulin resistance

verfasst von: Alice Fanin, Lucia Miele, Emanuela Bertolini, Alessia Giorgini, Antonio Ettore Pontiroli, Alberto Benetti

Erschienen in: Internal and Emergency Medicine | Ausgabe 2/2020

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Abstract

Background

Liver dysfunction has been widely reported in connection with anorexia nervosa (AN) but the pathogenesis of these alterations has never been fully understood despite reported theories about the presence of insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD). The aim of this study is to investigate if hypertransaminasemia in AN is linked to IR and NAFLD.

Methods

Anthropometric data and laboratory exams of 34 patients and 34 controls were analyzed, including alanine-aminotransferase, aspartate-aminotransferase and homeostatic model assessment of insulin resistance (HOMA-IR) index. All subjects also underwent magnetic resonance imaging (MRI), ultrasonography (US), and transient elastography (TE).

Results

Evidence of increased alanine aminotransferase in AN patients was confirmed in our sample together with a lower HOMA-IR index compared to controls. Positive results in US appeared in 16 patients vs none in controls (p = 0.0007); patients with liver parenchyma abnormalities in US were not different than normal-US patients in any of the studied variables. Only one patient showed non-alcoholic fatty liver disease in MRI while abnormal TE was found in four patients and never in controls.

Conclusions

Liver damage suggested by increased serum liver enzymes cannot be due to liver steatosis but potentially to a different liver disease (not identified by MRI) or to an early liver fibrosis not associated with an insulin-resistant status.

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Titel: Liver alterations in anorexia nervosa are not caused by insulin resistance
verfasst von: Alice Fanin
Lucia Miele
Emanuela Bertolini
Alessia Giorgini
Antonio Ettore Pontiroli
Alberto Benetti
Publikationsdatum: 16.11.2019
Verlag: Springer International Publishing
Erschienen in: Internal and Emergency Medicine / Ausgabe 2/2020
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-019-02227-9

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Liver alterations in anorexia nervosa are not caused by insulin resistance