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To the Editor: Insulin resistance (IR) and features of the metabolic syndrome are often associated with nonalcoholic fatty liver disease (NAFLD). Insulin resistance has been considered to be essential for the development of NAFLD.¹ However, multiple mechanisms are involved in the pathogenesis of NAFLD.² We previously described a form of NAFLD among petrochemical workers, affecting predominantly younger men, causing mild fibrosis and cholestasis.^3-4 In the current study we evaluated the relationship of IR to NAFLD among petrochemical workers.

Methods

Forty petrochemical workers with the diagnosis of NAFLD who presented with abnormal alanine aminotransferase, aspartate aminotransferase, and -glutamyltransferase levels on 3 or more determinations, were referred to the Hepatology Clinic, Federal University of Bahia, Brazil, between March 2001 and November 2003. All had a history of occupational exposure to chemicals (benzene, xylene, ethylene, dimethylformamide, vinyl chloride, and others) for at least 5 years. Patients, corroborated by family members, indicated the absence of . . . [Full Text of this Article]

Helma P. Cotrim, MD
hpcotrim@ufba.br

Fernando Carvalho, MD; Ana Cristina Siqueira, MD; Marina Lordelo; Raquel Rocha, MSc
School of Medicine
Universidade Federal da Bahia

Luiz A. R. De Freitas, MD
CPqGM (Gonçalo Muniz Research Center)–FIOCRUZ (Osvaldo Cruz Foundation)
Bahia, Brazil