Nonalcoholic fatty liver and metabolic syndrome in Italy: results from a multicentric study of the Italian Arteriosclerosis society

Abstract

Nonalcoholic fatty liver disease (NAFLD) is associated with all the components of metabolic syndrome (MS) and might to be considered an additional component of MS itself. The Italian Society for the Study of Atherosclerosis (SISA) in 2005 started a research project aimed to study the NAFLD, using ultrasound (US), in nondiabetic MS subjects matching at least one of the ATP III criteria for HDL-C or triglycerides [TG]. Prevalence of US-NAFLD and its associated risk factors and prevalence of hypertransaminasemia and its possible determinants were evaluated. NAFLD prevalence was 0.78. Men with steatosis compared to men without steatosis were younger (P < 0.05) with higher TG (P < 0.03), homeostasis model assessment insulin resistance (HOMA-R) (P < 0.003), and visceral fat thickness (VFT) (P < 0.0001). Women with steatosis showed higher TG (P < 0.05), HOMA-R (P < 0.04), VFT (P < 0.0001), and lower age (P < 0.05). At multivariate analyses, VFT (P < 0.0001), HOMA-R (P < 0.02), and TG/HDL (P < 0.05) were associated with severity of NAFLD. Age (P < 0.05), LogTG (P < 0.005), and VFT (P < 0.01) were associated with higher ALT. The US prevalence of steatosis in this study (0.78) is the highest reported in patients with MS. Considering the exclusion of severe obese and diabetic patients and the recruitment criteria, this finding highlights the prominent role played by the alterations of lipid metabolism in the pathogenesis of NAFLD.

644 Surveillance Program for Diagnosis of HCC in Liver Cirrhosis: Role of Ultrasound Echopatterns

“…However, all the studies conducted so far have the limitation of being retrospective and performed with older generation ultrasound equipment. In our study, the value, using Landis's score, ranged between 0.79 and 1, which suggests that ultrasound has a good degree of reproducibility in defining the different echo patterns of liver cirrhosis, when it is performed by expert operators with specific training using up-to-date equipment as already demonstrated in previous US studies [21,24] and according to what is recommended by current guidelines [1].…”

“…Before the study, the ultrasound operators agreed on general roles to follow in the procedure of examination, and they participated in a short training program according to previous ultrasound studies performed in other training [21,24].…”

“…LC was diagnosed by histology in 20% of cases; in the remaining cases diagnosis was made on the basis of clinical (presence of spider nevi, palmar erythema, and ascites), endoscopic (esophageal varices or congestive gastropathy), ultrasound (irregular liver surface, hypertrophy of the left segments, ascites, and signs of portal hypertension) parameters [24], and laboratory abnormalities (INR elongation, hypoalbuminemia, increased gamma globulin, and thrombocytopenia). Patients with LC were staged according to the Child-Pugh clinical classification [17].…”

Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention

“…The two major available studies, conducted on a large cohort of Italian patients with T2DM, reported NAFLD prevalence of 60-70% 33,34 ; data from the UK suggests that NAFLD, detected ultrasonographically, is present in 42.6% of patients with T2DM 35 . Prevalence of NAFLD also increases with BMI, such that in an unselected Italian population sample 91% of patients who were obese (BMI ≥30 kg/m 2 ), 67% of those who were overweight (BMI 25-30 kg/m 2 ) and 25% of individ uals at a normal weight (BMI 18-25 kg/m 2 ) had ultra sonographical evidence of NAFLD 36 .…”

“…Prevalence of NAFLD also increases with BMI, such that in an unselected Italian population sample 91% of patients who were obese (BMI ≥30 kg/m 2 ), 67% of those who were overweight (BMI 25-30 kg/m 2 ) and 25% of individ uals at a normal weight (BMI 18-25 kg/m 2 ) had ultra sonographical evidence of NAFLD 36 . The prevalence of NAFLD among patients matching at least one of the Adult Treatment Panel III (ATP III) criteria for serum lipid level alterations is similarly high at 78.8% 33 .…”