Identify factors associated with preserved hepatic insulin sensitivity despite of hepatic steatosis.

Among all the evaluated factors, only adipose tissue insulin sensitivity (assessed by clamped % suppression of serum free fatty acid), serum concentration of high molecular weight adiponectin, and plasma concentration of TCA cycle metabolites such as citric acid and cis-aconitic acid (assessed by metabolome analysis), associated significantly and positively with hepatic insulin sensitivity in NAFLD. We analyzed the data to identify factors associated with preserved hepatic insulin sensitivity despite of hepatic steatosis. The 26 NAFLD patients with intrahepatic lipid content of >5% were divided into three groups according to the level of hepatic insulin sensitivity, as assessed by clamped % suppression of endogenous glucose production. Then, all the evaluated factors were compared between the hepatic insulin sensitive and resistant patients with comparable hepatic steatosis (n=9 vs 8, respectively).