オノ　マサフミ   Ono Masafumi   小野　正文    所属   医学部 医学科（附属足立医療センター）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	High fasting insulin concentrations may be a pivotal predictor for the severity of hepatic fibrosis beyond the glycemic status in non-alcoholic fatty liver disease patients before development of diabetes mellitus.
掲載誌名	正式名：Hepatology research : the official journal of the Japan Society of Hepatology 略　 称：Hepatol Res ISSNコード：13866346/13866346
掲載区分	国内
巻・号・頁	47(10),pp.983-990
著者・共著者	Masuda Kosei, Noguchi Shuhei, Ono Masafumi, Ochi Tsunehiro, Munekage Kensuke, Okamoto Nobuto, Suganuma Narufumi, Saibara Toshiji
発行年月	2017/09
概要	BACKGROUND:Insulin resistance and type 2 diabetes mellitus (T2DM) contribute to the progression of non-alcoholic fatty liver disease (NAFLD). However, the relationship between glucose metabolic factors and the histological severity in NAFLD patients before development of T2DM is not well known.METHODS:In 103 biopsy-proven NAFLD patients (68 men and 35 women) with hemoglobin A1c of <6.5% and fasting blood glucose of <126 mg/dL, we investigated whether glucose metabolic factors influenced the severity of hepatic fibrosis without prior known T2DM.RESULTS:Female gender, age, serum aspartate aminotransferase, the aspartate aminotransferase/alanine aminotransferase ratio, fasting immunoreactive insulin (f-IRI), homeostasis model assessment - insulin resistance, hemoglobin A1c, hyaluronic acid, and type IV collagen 7 s were significantly higher, and 1,5-anhydroglucitol was significantly lower, in the fibrosis stage F3 group than in the F0-2 group. Multiple logistic regression analysis showed that only f-IRI (P = 0.006; odds ratio, 1.15151; 95% confidence interval, 1.04198-1.27254) was significantly indicated as a predictive factor for F3. As determined by both forward and backward stepwise selection analyses to optimize the model, f-IRI (P = 0001; odds ratio, 1.16788) remained an independent predictive factor for F3. To discriminate the F3 group from the F0-2 group, the area under the receiver operating characteristic curves showed that fasting insulin was 0.7219, and the best cut-off value of f-IRI was 13.2 μU/mL in the receiver operating characteristic curve analysis.CONCLUSIONS:High fasting insulin concentrations may be a pivotal glucose metabolic predictor for the severity of hepatic fibrosis beyond the glycemic status in NAFLD patients before development of T2DM.
DOI	10.1111/hepr.12832
PMID	27794176