Hypolactasia is associated with insulin resistance in nonalcoholic steatohepatitis

Table 1 Demographic, clinical and biochemical characteristics of the non-alcoholic fatty liver disease patients

	Steatosis (n = 9)	NASH (n = 93)	P value
Age	55.11 ± 10.3	56.51 ± 10.13	0.692
Men/women (n)	0% (0)/100% (9)	34.41% (32)/65.59% (61)	0.04a
Type 2 diabetes (n)	33.33% (2)	60.67% (54)	0.224
Dyslipidaemia (n)	83.33% (5)	79.78% (71)	1
High-blood pressure (n)	66.67% (4)	64.04% (89)	1
BMI	31.28 ± 5.79	31.25 ± 5.93	0.969
Fasting glucose (mg/dL)	91.71 ± 9.2	123.14 ± 48.28	0.033a
Insulin (μU/mL)	12.44 ± 4.2	19.92 ± 13.29	0.102
HOMA-IR value ≥ 2.5	57.14%	83.53%	0.115
AST (U/L)	25.14 ± 6.89	38.8 ± 37.99	0.159
ALT (U/L)	40 ± 16.74	50.65 ± 54.99	0.934
GGT (U/L)	56.57 ± 59.9	87.36 ± 96.33	0.185
Total cholesterol (mg/dL)	203.29 ± 54.39	195.31 ± 45.71	0.863
HDL (mg/dL)	53 ± 6.58	46.15 ± 13.42	0.067
LDL (mg/dL)	124.14 ± 51.87	114.89 ± 39.74	0.72
Triglycerides (mg/dL)	130.43 ± 59.19	167.25 ± 82.02	0.258

^aP value < 0.05. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; HDL: High-density lipoprotein; HOMA-IR: Homeostatic Model of Assessment; LDL: Low-density lipoprotein; GGT: Gamma glutamyl transferase; NASH: Nonalcoholic steatohepatitis.

Table 2 Allele and genotype frequencies of the lactase-13910C>T polymorphisms

		Allele frequency % (n)a		Total (%)	Genotype frequency % (n)b			Total (%)
		C	T		CC	CT	TT
LCT-13910	Control (n = 501)	76.95 (768)	23.05 (230)	100	59.12 (295)	35.67 (178)	5.21 (26)	100
	Steatosis (n = 9)	83.33 (15)	16.67 (3)	100	66.67 (6)	33.33 (3)	0 (0)	100
	NASH (n = 93)	75.81 (141)	24.19 (43)	100	55.91 (52)	39.78 (37)	4.3 (3)	100

^aP = 0.764;

^bP = 0.941. NASH: Nonalcoholic steatohepatitis; LCT: Lactase gene.

Table 3 Associations of the lactase-13910 phenotype in nonalcoholic steatohepatitis patients (n = 93)

	Hypolactasia	Lactase persistence	P value
Age	55.96 ± 10.91	57.61 ± 9.33	0.443
Gender: Female % (n)	70.83 (34)	60.98 (25)	0.51
Type 2 diabetes % (n)	66.67 (30)	57.5 (23)	0.664
Dyslipidaemia % (n)	82.22 (37)	77.5 (31)	0.792
High-blood pressure % (n)	68.89 (31)	57.5 (23)	0.273
BMI	31.39 ± 6.55	31.28 ± 5.37	0.714
BMI ≥ 30 % (n)	58.14 (25)	65 (26)	0.388
Fasting glucose (mg/dL)	122.61 ± 50.14	123.83 ± 46.43	0.892
Insulin (μU/mL)	23.47 ± 15.94	15.8 ± 8.33	0.027a
HOMA-IR value ≥ 2.5 (n)	91.84 (45)	72.22 (26)	0.02a
AST (U/L)	38.94 ± 37.66	42.67 ± 40.15	0.121
ALT (U/L)	51.47 ± 69.44	52.12 ± 35.02	0.072
GGT (U/L)	97.49 ± 118.27	80.51 ± 65.6	0.427
Total cholesterol (mg/dL)	196.62 ± 47.13	195.55 ± 44.06	0.965
HDL (mg/dL)	46.38 ± 12.26	46.05 ± 15.06	0.698
LDL (mg/dL)	117.19 ± 39.47	114.25 ± 39.9	0.893
Triglycerides (mg/dL)	169.11 ± 82.97	162.3 ± 83.11	0.477
Steatosis
1	21.28 (10)	24.39 (10)	0.453
2	51.06 (24)	39.02 (16)
3	27.66 (13)	36.59 (15)
Inflammation
0	2.13 (1)	7.32 (3)	0.133
1	61.7 (29)	46.34 (19)
2	23.4 (11)	39.02 (16)
3	12.77 (6)	7.32 (3)
Fibrosis
0	18.75 (9)	14.63 (6)	0.804
1	39.58 (19)	43.9 (18)
2	16.67 (8)	17.07 (7)
3	20.83 (10)	19.51 (8)
4	4.17 (2)	4.88 (2)
MetS	51.92 (27)	53.66 (19)	1

^aP value < 0.05. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; HDL: High-density lipoprotein; HOMA-IR: Homeostatic Model of Assessment; LDL: Low-density lipoprotein; GGT: Gamma glutamyl transferase; MetS: Metabolic syndrome.

Table 4 Multivariate logistic regression analysis in nonalcoholic steatohepatitis patients

Factor	OR	95%CI	P value
HOMA-IR value ≥ 2.5
Hypolactasia phenotype	5	1.35-20	0.017a
CT genotype	0.16	0.04-0.64	0.009a
TT genotype	-	-	0.994
BMI ≥ 30
Hypolactasia phenotype	0.49	0.13-1.81	0.285
CT genotype	1.73	0.69-4.35	0.244
TT genotype	1.01	0.12-8.39	0.991
Insulin > 29.8
Hypolactasia phenotype	2.04	0.68-6.25	0.197
CT genotype	0.52	0.17-1.56	0.25
TT genotype	-	-	0.991
MetS
Hypolactasia phenotype	0.94	0.47-2.42	0.89
CT genotype	1.07	0.46-2.49	0.866
TT genotype	0.91	0.11-7.3	0.929

^aP value < 0.05. HOMA-IR: Homeostatic Model of Assessment; OR: Odds ratio; BMI: Body mass index; MetS: Metabolic syndrome.