Prevalence of metabolic syndrome in non-diabetic and non-cirrhotic patients with non-alcoholic steatohepatitis.

Recently, insulin resistance (IR) was proposed as a primary pathogenic mechanism in non-alcoholic steatohepatitis (NASH). The prevalence of IR and metabolic syndrome remains largely unstudied in patients with NASH and without diabetes and cirrhosis, both being conditions associated with IR. During a 1-year period, all non-diabetic and noncirrhotic patients seen in our institute with a diagnosis of NASH were subjected to anthropometric measurements, clinical examination, lipid profile and glucose tolerance test to define metabolic syndrome. All the patients underwent test for fasting glucose and insulin levels to define the insulin resistance by HOMA-R (homeostasis model assessment) method. Of the 25 patients with NASH, the metabolic syndrome was present in 17 (68%) and at least one criterion for the metabolic syndrome was present in all the patients. IR was present in 20 patients (80%). All the patients were either overweight (8%) or obese (92%). Because of the high prevalence of the metabolic syndrome and IR in patients with NASH, it is pertinent to test for IR and metabolic abnormalities in all patients with NASH. Also, all patients with metabolic syndrome should undergo liver function tests and, in the presence of abnormal transaminases, a liver biopsy to define NASH.