Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 30: Can A Patient Of Normal Body Weight, A Normal Serum Cholesterol Level, And No History Of Diabetes Have Fatty Liver Disease? (continued)

Arun J. Sanyal, MD

Metabolic syndrome as defined by dyslipidemia, diabetes mellitus, and obesity is almost universally associated with nonalcoholic fatty liver disease (NAFLD). The driving force behind the phenotypic expression of both metabolic syndrome and NAFLD is insulin resistance (IR). While typically IR is associated with diabetes, obesity, and dyslipidemia, it may be present in individuals with no overt expression of metabolic syndrome. It has also been seen that patients with familial insulin resistance syndrome who are often nonobese and have high prevalence of not only NAFLD but also known to…