This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Nonalcoholic fatty liver disease (NAFLD) is a liver disease characterized by diffuse fatty infiltration and inflammation in those who do not consume any alcohol 1. The exact prevalence of NAFLD is unknown; however, based on the known prevalence of benign steatosis and steatohepatitis in those with obesity and type 2 diabetes, NAFLD is now estimated to be the third leading cause of chronic liver disease in the United States 2. Given that the prevalence of obesity could reach 40% by the year 2025 3, it is clear NAFLD is a significant current and future public health concern. NAFLD may be an early manifestation of insulin resistance (IR), but it remains unclear whether IR is associated with NAFLD or an extraneous factor present in those patients with NAFLD. IR may purely be associated with obesity and/or reflect the presence of underlying liver disease irrespective of the presence of steatosis. Since insulin is primarily cleared by the liver, discerning whether hyperinsulinemia is secondary to impaired hepatic clearance or overproduction of insulin is important.
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