Supplementary Table 1. Newcastle-Ottawa Quality Assessment Scale. Supplementary Table 2. Cochrane Risk of Bias Study-by-Study Table. Supplementary Figure 1. Risk of bias Graph: review authors' judgments about each domain of the Newcastle-Ottawa scale presented as percentages across all included studies.

Our findings suggest that there is an inverse, graded, association between RDW and kidney function tests in a large cohort of unselected adult outpatients.

Although lifestyle interventions are considered the first-line therapy for nonalcoholic fatty liver disease (NAFLD), which is extremely common in people with type 2 diabetes, no intervention studies have compared the effects of aerobic (AER) or resistance (RES) training on hepatic fat content in type 2 diabetic subjects with NAFLD. In this randomized controlled trial, we compared the 4-month effects of either AER or RES training on insulin sensitivity (by hyperinsulinemic euglycemic clamp), body composition (by dual-energy X-ray absorptiometry), as well as hepatic fat content and visceral (VAT), superficial (SSAT), and deep (DSAT) subcutaneous abdominal adipose tissue (all quantified by an in-opposed-phase magnetic resonance imaging technique) in 31 sedentary adults with type 2 diabetes and NAFLD. After training, hepatic fat content was markedly reduced (P < 0.001), to a similar extent, in both the AER and the RES training groups (mean relative reduction from baseline [95% confidence interval] 232.8% [258.20 to 27.52] versus 225.9% [250.92 to 20.94], respectively). Additionally, hepatic steatosis (defined as hepatic fat content >5.56%) disappeared in about one-quarter of the patients in each intervention group (23.1% in the AER group and 23.5% in the RES group). Insulin sensitivity during euglycemic clamp was increased, whereas total body fat mass, VAT, SSAT, and hemoglobin A1c were reduced comparably in both intervention groups. Conclusion: This is the first randomized controlled study to demonstrate that resistance training and aerobic training are equally effective in reducing hepatic fat content among type 2 diabetic patients with NAFLD. (HEPATOLOGY 2013;58:1287-1295

OBJECTIVE -Nonalcoholic fatty liver disease (NAFLD) is closely associated with several metabolic syndrome features. We assessed whether NAFLD is associated with carotid artery intima-media thickness (IMT) as a marker of subclinical atherosclerosis and whether such an association is independent of classical risk factors, insulin resistance, and metabolic syndrome features. RESEARCH DESIGN AND METHODS-We compared carotid IMT, as assessed by ultrasonography, in 85 consecutive patients with biopsy-proven NAFLD and 160 age-, sex-, and BMI-matched healthy control subjects.RESULTS -NAFLD patients had a markedly greater carotid IMT (1.14 Ϯ 0.20 vs. 0.82 Ϯ 0.12 mm; P Ͻ 0.001) than control subjects. The metabolic syndrome (according to Adult Treatment Panel III criteria) and its individual components were more frequent in those with NAFLD (P Ͻ 0.001). The marked differences in carotid IMT observed between the groups were only slightly weakened after adjustment for age, sex, BMI, smoking history, LDL cholesterol, insulin resistance (by homeostasis model assessment), and metabolic syndrome components. Notably, carotid IMT was strongly associated with degree of hepatic steatosis, necroinflammation, and fibrosis among NAFLD patients (P Ͻ 0.001 for all). Similarly, by logistic regression analysis, the severity of histological features of NAFLD independently predicted carotid IMT (P Ͻ 0.001) after adjustment for all potential confounders.CONCLUSIONS -These results suggest that the severity of liver histopathology among NAFLD patients is strongly associated with early carotid atherosclerosis, independent of classical risk factors, insulin resistance, and the presence of metabolic syndrome. Diabetes Care 29:1325-1330, 2006N onalcoholic fatty liver disease (NAFLD), the most common cause of abnormal liver function tests in hepatology practice, is frequently associated with visceral obesity, dyslipidemia, insulin resistance, and type 2 diabetes and may represent another component of the metabolic syndrome (1-3).Recent cross-sectional studies (4 -6) have shown that NAFLD is associated with increased carotid artery intimamedia thickness (IMT), a marker of early generalized atherosclerosis (7). However, in these studies the NAFLD diagnosis was exclusively based on ultrasound imaging but was not confirmed by liver biopsy, which is the best diagnostic tool for confirming NAFLD (1-3).Thus, currently it is uncertain whether there is a significant association between early carotid atherosclerosis and the severity of liver histology among NAFLD patients. Clarification of this aspect may help to explain the underlying mechanisms and may be of clinical importance in planning preventive and therapeutic strategies.We have, therefore, assessed whether patients with biopsy-proven NAFLD have a greater carotid IMT than control subjects and whether there is a significant association between liver histology and carotid IMT among NAFLD patients. RESEARCH DESIGN ANDMETHODS -A total of 85 consecutive outpatients with NAFLD were recruited from clinics, 50...