Fatty Liver and Metabolic Syndrome in Nonabdominally Obese Taiwanese Adults

Chang, Tsui-Yen; Chen, Jong-Dar

doi:10.1177/1010539511402191

Cited by 10 publications

(12 citation statements)

References 36 publications

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“…It has been demonstrated by several studies that higher risk of metabolic disorders is found in patients with NAFLD than in those without it. 15 , 16 However, since data on metabolic disorders and NAFLD were collected and analyzed cross-sectionally, the causal association between metabolic disorders and NAFLD is unclear. Moreover, although there was a significant association between diabetes and NAFLD, 17 neither a history of diabetes nor high FBG served as an independent risk factor for NAFLD on multivariate analyses suggesting that diabetes is a confounding factor.…”

Section: Discussionmentioning

confidence: 99%

Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

Lesmana¹,

Pakasi²,

Inggriani³

et al. 2015

DMSO

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BackgroundNon-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the community. However, NAFLD remains undiagnosed in most people with limited access to imaging facilities in most developing countries.ObjectiveTo examine the prevalence of NAFLD and to develop the risk scoring model for predicting the presence of NAFLD among adult medical check-up patients.MethodA large prospective cross-sectional study was conducted among medical check-up patients who underwent transabdominal ultrasound examination between January and December 2013 in Medistra Hospital, Jakarta. Data were obtained from the patients’ medical records. Logistic regression analyses were undertaken to identify the best combination of risk factors for predicting fatty liver using the backward (likelihood ratio) approach. The adjusted odds ratio and 95% confidence interval were estimated using the logistic regression coefficient. The prediction model was assessed using the receiver operating characteristic curve and the Hosmer–Lemeshow goodness-of-fit test and was validated on a new, prospective cohort. Statistical analysis was done using SPSS version 17.ResultsA total of 1,054 cases was included in this study. Fatty liver was present in 538 (51.0%) patients. Bivariate analyses found associations among fatty liver and several risk factors. Six risk factors were incorporated to build the final prediction model. All scores were summed up to obtain the total score. A probability equation was developed by applying linear regression analysis on the total score. The prediction model had good diagnostic performance with an area under the receiver operating characteristic curve =0.833 (95% confidence interval =0.809–0.857). The Hosmer–Lemeshow goodness-of-fit P-value was 0.232, which indicated the appropriateness of the logistic regression model to predict fatty liver. On the validation set, the scoring system proved to be moderately accurate and can potentially be applied to larger population setting.ConclusionThe presence of fatty liver in NAFLD patients can be predicted using our proposed fatty liver scoring system.

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Section: Discussionmentioning

confidence: 99%

Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

Lesmana¹,

Pakasi²,

Inggriani³

et al. 2015

DMSO

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“…Increased fat accumulation in the liver may suppress hepatic insulin clearance and lead to hyperinsulinemia or hyperglycemia (30); this effect is independent of obesity (31). Several earlier studies demonstrated a higher risk of metabolic disorders in patients with NAFLD than in those without (17,21). However, since data on metabolic disorders and NAFLD were collected and analyzed cross-sectionally, the causal association between metabolic disorders and NAFLD is unclear.…”

Section: Discussionmentioning

confidence: 94%

“…Although a large body of evidence was identified in the literature regarding the cross-sectional association between metabolic disorders and NAFLD (15,17–22,28), the longitudinal effect of MS on the development of NAFLD was unclear. An earlier survey in Shanghai, China including 3,175 middle-aged adults, identified that participants with metabolic disorders, including central obesity, diabetes, dyslipidemia or hypertension, increased the risk of fatty liver by 33-, 32-, 23- or 23-fold, respectively (19).…”

Section: Discussionmentioning

confidence: 99%

“…However, no evidence was provided regarding the causal association between NAFLD and MS. The majority of previous studies on the association between MS and NAFLD were based on a cross-sectional design (15,17–22); thus, the temporal sequence was unclear. We identified only one prospective study, involving 3,147 Japanese adults without NAFLD at baseline, in which the presence of MS was associated with the development of NAFLD, after following up for one year (13).…”

Section: Introductionmentioning

confidence: 99%

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Association between metabolic syndrome and the development of non-alcoholic fatty liver disease

Wang

Nie

et al. 2013

Experimental and Therapeutic Medicine

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The aim of this study was to examine the effects of metabolic syndrome (MS) and the number of MS components on the development of non-alcoholic fatty liver disease (NAFLD). A total of 1,343 males and 574 females aged ≥50 years without NAFLD at baseline were included. Information on lifestyle, including alcohol use and personal history, was collected by face-to-face interviews. Biochemical parameters were assayed using fasting blood samples. NAFLD was diagnosed by abdominal ultrasonography. During follow-up at an average of 4.8 years, 223 patients developed NAFLD. Following adjustment for multiple covariates, age was an independent protective predictor [hazard ratio (HR), 0.96; 95% confidence interval (CI), 0.95–0.98], while the independent risk predictors were obesity (HR, 2.81; 95% CI, 2.14–3.69), higher triglycerides (HR, 2.56; 95% CI, 1.95–3.32) and alanine aminotransferase (HR, 1.004; 95% CI, 1.000–1.008). Participants with a diagnosis of MS had a significantly increased risk of developing NAFLD (HR, 3.17; 95% CI, 2.42–4.14). A greater number of MS components was significantly associated with a higher risk of NAFLD (all adjusted P for trend <0.001). Compared with those without any components of MS, participants with only one component of MS had a 3.6-fold higher risk of developing NAFLD (adjusted HR, 3.64; 95% CI, 1.50–8.88). The diagnosis and the number of components of MS were prospectively associated with the risk of developing NAFLD. Even in those with only one component of MS, the risk increased by 2.6-fold compared with that for the individuals without any components, suggesting a beneficial effect of intervention at the very early stage of MS on the prevention of NAFLD.

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“…Several studies even demonstrated that the quantity of liver fat was more closely linked to the metabolic complications of obesity than that of visceral fat. Chang and Chen displayed subjects with only NAFLD had a greater odds ratio for developing abnormal MetS components than those with only abnormal WC [ 20 ]. Stefan et al reported that liver fat had stronger correlation with insulin sensitivity than visceral adipose tissue among the obese subjects [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Fatty Liver as a Potential Surrogate for Waist Circumference in the Diagnosis of Metabolic Syndrome: A Population-Based Study among Chinese Adults

Jiang

Zhou

et al. 2018

International Journal of Endocrinology

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Increased waist circumference (WC) is an essential component of metabolic syndrome (MetS). Asians have been found to have more intra-abdominal adipose tissue than Caucasians, in spite of having smaller WC. The purpose of this study was to explore whether NAFLD could be used as a surrogate for MetS diagnosis in the normal WC population. A total of 9694 Chinese residents were selected from SPECT-China, a population-based survey of Chinese adults aged ≥ 18 years in East China. Insulin resistance was calculated by the homeostatic model assessment for insulin resistance (HOMA-IR). MetS z-score was used to evaluate the degree of total metabolic disorder. Logistic regression models were used to obtain the associations between different categories and metabolic syndrome (MetS) components. The prevalence of NAFLD was 27.6%, in which 35.2% were without abnormal WC. Subjects with only NAFLD had similarly severe insulin resistance and OR for clustering of MetS components compared with those with only abnormal WC. A considerable number of NAFLD cases, although had severe metabolic disorder, would not be detected by the current MetS definition. NAFLD could be used as a potential surrogate marker for the diagnosis of MetS in normal WC population.

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Fatty Liver and Metabolic Syndrome in Nonabdominally Obese Taiwanese Adults

Cited by 10 publications

References 36 publications

Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

Development of non-alcoholic fatty liver disease scoring system among adult medical check-up patients: a large cross-sectional and prospective validation study

Association between metabolic syndrome and the development of non-alcoholic fatty liver disease

Fatty Liver as a Potential Surrogate for Waist Circumference in the Diagnosis of Metabolic Syndrome: A Population-Based Study among Chinese Adults

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