Elevated Cholinesterase Activity and the Metabolic Syndrome—Dissecting Fatty Liver, Insulin Resistance and Dysglycaemia

• DOI: 10.1111/liv.70046
• Publication Date: 2025-04-17T12:57:27Z
• Authors: Martin Heni; Julia Hummel; Louise Fritsche; Robert Wagner; Lasse Relker; Jürgen Machann; Fritz Schick; Andreas L. Birken...; Erwin Schleicher; Alfred Königsrainer; Hans‐Ulrich Häring; Norbert Stefan; Andreas Fritsche; Andreas Peter
• Keywords: Butyrylcholinesterase; Steatosis

ABSTRACT Background and Aims While low plasma butyrylcholinesterase (BChE) is a well‐established marker of reduced liver synthesis capacity, the clinical significance elevated BChE unclear. In small studies, high has long been suspected in hepatic steatosis metabolic syndrome. We aimed to clarify relation between BChE, fat glucose metabolism deeply phenotyped cohorts. Methods Plasma activity was measured 844 humans (554 women) cross‐sectional Tübingen Diabetes Family Study, with wide BMI range (17.7–55.1 kg/m 2 ). It furthermore before after two independent lifestyle intervention studies 215 116 participants. Liver quantified 1 H‐MR‐spectroscopy, assessed by oral tolerance tests. Results positively associated fat, sex, age BMI. higher participants fasting 2‐h glycaemia, negatively insulin sensitivity, age, fat. The reduction improvement sensitivity during interventions are body weight loss. Conclusions Higher linked accumulation, as well impaired resistance, This suggests that could be for processes hepatocytes contribute metabolism. Further investigations needed mechanistic contribution potential diagnostic value diseases.