Effect of iron depletion in carbohydrate-intolerant patients with clinical evidence of nonalcoholic fatty liver disease
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Background & aims Increased body iron, genetic hemochromatosis (GH) mutations, and nonalcoholic fatty liver disease (NAFLD) tend to cluster in carbohydrate-intolerant patients. In an attempt to further clarify the interrelationships among these conditions, we studied 42 carbohydrate-intolerant patients who were free of the common GH mutations C282Y and H63D, and had a serum iron saturation lower than 50%.Methods We measured body iron stores, and induced iron depletion to a level of near-iron deficiency (NID) by quantitative phlebotomy.Results In the 17 patients with clinical evidence of NAFLD, we could not demonstrate supranormal levels of body iron (1.6 +/- 0.2 vs. 1.4 +/- 0.2 g; P = 0.06). However, at NID, there was a 40%-55% improvement (P = 0.05-0.0001) of both fasting and glucose-stimulated plasma insulin concentrations, and near-normalization of serum alanine aminotransferase activity (from 61 +/- 5 to 32 +/- 2 IU/L; P < 0.001).Conclusions These results reflect the insulin-sparing effect of iron depletion and indicate a key role of iron and hyperinsulinemia in the pathogenesis of NAFLD.
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Iron is strongly implicated in non-alcoholic steatohepatitis, considered an early marker of insulin resistance.
“Iron is also strongly implicated in non-alcoholic steatohepatitis, considered an early marker of insulin resistance [622-624].”
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- Authors
- Facchini, F. S., Hua, N. W., & Stoohs, R. A.
- Affiliations
- San Francisco General Hospital (US)
- Stanford Medicine (US)
- ORCID
- Stoohs, Riccardo A.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 122
- Issue
- 4
- Pages
- 931-939
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2135385594
- Cited by
- 233
- References
- 53
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 13 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 10 · 2015: 15 · 2014: 10 · 2013: 11 · 2012: 11
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- Kaiser Foundation Research Institute
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Keywords
- non-alcoholic fatty liver disease, iron depletion, carbohydrate intolerance, iron deficiency, iron stores, insulin resistance, hyperinsulinemia, insulin-sparing effect, alanine aminotransferase, hereditary hemochromatosis
- MeSH terms
- Adult, Alanine Transaminase, Blood Glucose, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Fatty Liver, Female, Hemochromatosis, Humans, Hyperinsulinism, Insulin, Iron, Male, Middle Aged, Phlebotomy
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