Plasma apolipoprotein C3 concentrations, insulin sensitivity, and hepatic triglyceride content were measured. We also measured plasma triglyceride concentrations and retinyl Selleck LY294002 fatty acid ester absorption
as well as plasma triglyceride clearance after oral and intravenous fat-tolerance tests. Liver triglyceride content and APOC3 genotypes were also assessed in a group of 163 healthy non-Asian Indian men. Results: Carriers of the APOC3 variant alleles (C-482T, T-455C, or both) had a 30% increase in the fasting plasma apolipoprotein C3 concentration, as compared with the wild-type homozygotes. They also had a 60% increase in the fasting plasma triglyceride concentration, an increase by a factor of approximately two in the plasma triglyceride and retinyl fatty acid ester concentrations after an oral fat-tolerance test, and a 46% reduction in plasma triglyceride clearance. The prevalence of nonalcoholic fatty liver disease was 38% among variant-allele carriers and 0% among wild-type homozygotes (P<0.001). The subjects with nonalcoholic fatty liver disease had marked insulin resistance. A validation study involving non-Asian Indian men confirmed the association between APOC3 variant alleles and nonalcoholic fatty liver disease. Conclusions:
The polymorphisms C-482T and T-455C in APOC3 are associated with nonalcoholic fatty Cilomilast price liver disease and insulin resistance. Burgeoning waistlines and a more sedentary lifestyle have resulted in nonalcoholic fatty liver disease (NAFLD) becoming the most common cause of chronic liver disease in the Western world. The prevalence of NAFLD has been reported to be as high as 46% in the United States and is associated with obesity, diabetes, metabolic syndrome, and certain ethnicities, including Hispanics and Asian Indians.1 Interestingly, selleck chemical the prevalence of NAFLD is lower among African Americans despite high rates of diabetes, obesity, and metabolic syndrome.2 In addition, many patients with sedentary lifestyles (with or without diabetes)
may not develop fatty liver disease. This suggests that other factors are involved in the development of hepatic steatosis and steatohepatitis. The study by Petersen et al.3 in the March issue of the New England Journal of Medicine provides evidence that genotypic variations and particularly the genes encoding apolipoprotein C3 (APOC3) are important in the development of hepatic steatosis. This gene was selected for study because of its known association with hypertriglyceridemia, and Asian Indians were selected as the study cohort because of their high prevalence of NAFLD.4 Specifically, the authors genotyped two single-nucleotide polymorphisms (SNPs) in the APOC3 gene (rs2854116 and rs2854117) and showed that the presence of one or both of these alleles was associated with a 30% increase in the fasting plasma APOC3 concentration and a 60% increase in the fasting plasma triglyceride concentration.