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Clinical usefulness of non‐protein respiratory quotient measurement in non‐alcoholic fatty liver disease
Author(s) -
Korenaga Keiko,
Korenaga Masaaki,
Teramoto Fusako,
Suzuki Toshiko,
Nishina Sohji,
Sasaki Kyo,
Nakashima Yoshihiro,
Tomiyama Yasuyuki,
Yoshioka Naoko,
Hara Yuichi,
Moriya Takuya,
Hino Keisuke
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12095
Subject(s) - fatty liver , respiratory quotient , alcoholic liver disease , medicine , disease , gastroenterology , respiratory system , cirrhosis
Aim Little is known about the effects of non‐alcoholic fatty liver disease ( NAFLD ) on energy metabolism, although this disease is associated with metabolic syndrome. We measured non‐protein respiratory quotient (np RQ ) using indirect calorimetry, which reflects glucose oxidation, and compared this value with histological disease severity in NAFLD patients. Methods Subjects were 32 patients who were diagnosed with NAFLD histopathologically. Subjects underwent body composition analysis and indirect calorimetry, and np RQ was calculated. An oral glucose tolerance test was performed, and plasma glucose area under the curve ( AUC glucose) was calculated. Results There were no differences in body mass index, body fat percentage or visceral fat area among fibrosis stage groups. As fibrosis progressed, np RQ significantly decreased (stage 0, 0.895 ± 0.068; stage 1, 0.869 ± 0.067; stage 2, 0.808 ± 0.046; stage 3, 0.798 ± 0.026; P < 0.005). Glucose intolerance worsened and insulin resistance increased with fibrosis stage. np RQ was negatively correlated with AUC glucose ( R = −0.6308, P < 0.001), H omeostasis M odel of A ssessment – I nsulin R esistance ( R = −0.5045, P < 0.005), fasting glucose ( R = −0.4585, P < 0.01) and insulin levels ( R = −0.4431, P < 0.05), suggesting that decreased np RQ may reflect impaired glucose tolerance due to insulin resistance, which was associated with fibrosis progression. Estimation of fibrosis stage using np RQ was as accurate as several previously established scoring systems using receiver–operator curve analysis. Conclusion np RQ was significantly decreased in patients with advanced NAFLD . Our data suggest that measurement of np RQ is useful for the estimation of disease severity in NAFLD patients.