Hormonal
High plasma levels of alpha2-Heremans-Schmid glycoprotein (AHSG/fetuin-A) are associated with insulin resistance and hepatic fat accumulation in humans, and high baseline AHSG predicts a blunted improvement in insulin sensitivity following lifestyle intervention.
High levels of a liver-derived protein called AHSG are linked to insulin resistance and fatty liver. While you don't need to test for AHSG, the study shows that reducing liver fat through lifestyle changes (diet and exercise) lowers AHSG levels. Therefore, interventions that specifically target liver fat accumulation may improve insulin sensitivity more effectively, as high baseline AHSG predicts a slower improvement in sensitivity.
We found that high AHSG plasma levels are associated with insulin resistance in humans. Moreover, AHSG plasma levels are elevated in subjects with fat accumulation in the liver... high AHSG levels at baseline predicted less increase in insulin sensitivity (P < 0.02).
Why this rating
The study uses gold-standard measures (euglycemic-hyperinsulinemic clamp, 1H-MRS for liver fat) and includes longitudinal data, but the sample size is modest (n=106 cross-sectional, n=47 longitudinal) and restricted to healthy Caucasians.
Source
α2-Heremans-Schmid Glycoprotein/ Fetuin-A Is Associated With Insulin Resistance and Fat Accumulation in the Liver in Humans
Norbert Stefan et al. · Diabetes Care · 2006
DOI 10.2337/diacare.29.04.06.dc05-1938
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