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Genetic variants regulating insulin receptor signalling are associated with the severity of liver damage in patients with non-alcoholic fatty liver disease

Lookup NU author(s): Professor Ann DalyORCiD, Julian Leathart, Professor Alastair BurtORCiD, Professor Chris Day


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Background/aims: The aim of this study was to assess the effect of functional ENPP1(ectoenzyme nucleotide pyrophosphate phosphodiesterase 1)/PC-1 (plasma cell antigen-1) and IRS-1 (insulin receptor substrate-1) polymorphisms influencing insulin receptor activity on liver damage in non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of the metabolic syndrome, whose progression is associated with the severity of insulin resistance. Patients and methods: 702 patients with biopsy-proven NAFLD from Italy and the UK, and 310 healthy controls. The Lys121Gln ENPP1/PC-1 and the Gly972Arg IRS-1 polymorphisms were evaluated by restriction analysis. Fibrosis was evaluated according to Kleiner. Insulin signalling activity was evaluated by measuring phosphoAKT levels by western blotting in a subset of obese non-diabetic patients. Results: The ENPP1 121Gln and IRS-1 972Arg polymorphisms were detected in 28.7% and 18.1% of patients and associated with increased body weight/dyslipidaemia and diabetes risk, respectively. The ENPP1 121Gln allele was significantly associated with increased prevalence of fibrosis stage >1 and <2, which was higher in subjects also positive for the 972Arg IRS-1 polymorphism. At multivariate analysis, the presence of the ENPP1 121Gln and IRS-1 972Arg polymorphisms was independently associated with fibrosis <1 (OR 1.55, 95% CI 1.24 to 1.97; and OR 1.57, 95% CI 1.12 to 2.23, respectively). Both polymorphisms were associated with a marked reduction of ∼ 70% of AKT activation status, reflecting insulin resistance and disease severity, in obese patients with NAFLD. Conclusions: The ENPP1 121Gln and IRS-1 972Arg polymorphisms affecting insulin receptor activity predispose to liver damage and decrease hepatic insulin signalling in patients with NAFLD. Defective insulin signalling may play a causal role in the progression of liver damage in NAFL.

Publication metadata

Author(s): Dongiovanni P, Valenti L, Rametta R, Daly A, Nobili V, Mozzi E, Leathart J, Pietrobattista A, Burt A, Maggioni M, Fracanzani A, Lattuada E, Zappa M, Roviaro G, Marchesini G, Day C, Fargion S

Publication type: Article

Publication status: Published

Journal: Gut

Year: 2010

Volume: 59

Issue: 2

Pages: 267-273

Print publication date: 01/02/2010

ISSN (print): 0017-5749

ISSN (electronic): 1468-3288

Publisher: BMJ Group


DOI: 10.1136/gut.2009.190801


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