The Metabolic Syndrome as a Predictor of Nonalcoholic Fatty Liver Disease

医学 非酒精性脂肪肝 代谢综合征 内科学 国家胆固醇教育计划 脂肪肝 血脂异常 体质指数 前瞻性队列研究 腹部肥胖 优势比 全国健康与营养检查调查 肝病 疾病 肥胖 生理学 人口 环境卫生
作者
Masahide Hamaguchi,Takao Kojima,Noriyuki Takeda,Takayuki Nakagawa,Hiroya Taniguchi,Kimio Fujii,Tatsushi Omatsu,Tomoaki Nakajima,H Sarui,Makoto Shimazaki,Takahiro Kato,Junichi Okuda,Kazunori Ida
出处
期刊:Annals of Internal Medicine [American College of Physicians]
卷期号:143 (10): 722-722 被引量:1022
标识
DOI:10.7326/0003-4819-143-10-200511150-00009
摘要

The frequent association of nonalcoholic fatty liver disease with components of the metabolic syndrome such as obesity, hyperglycemia, dyslipidemia, and hypertension is well known. However, no prospective study has examined the role of the metabolic syndrome in the development of this disease.To characterize the longitudinal relationship between the metabolic syndrome and nonalcoholic fatty liver disease.A prospective observational study.A medical health checkup program in a general hospital.4401 apparently healthy Japanese men and women, 21 to 80 years of age, with a mean body mass index (BMI) of 22.6 kg/m2 (SD, 3.0).Alcohol intake was assessed by using a questionnaire. Biochemical tests for liver and metabolic function and abdominal ultrasonography were done. Modified criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.At baseline, 812 of 4401 (18%) participants had nonalcoholic fatty liver disease. During the mean follow-up period of 414 days (SD, 128), the authors observed 308 new cases (10%) of nonalcoholic fatty liver disease among 3147 participants who were disease-free at baseline and who completed a second examination. Regression of nonalcoholic fatty liver disease was found in 113 (16%) of 704 participants who had the disease at baseline and who completed a second examination. Men and women who met the criteria for the metabolic syndrome at baseline were more likely to develop the disease during follow-up (adjusted odds ratio, 4.00 [95% CI, 2.63 to 6.08] and 11.20 [CI, 4.85 to 25.87], respectively). Nonalcoholic fatty liver disease was less likely to regress in those participants with the metabolic syndrome at baseline.Ultrasonography may lead to an incorrect diagnosis of nonalcoholic fatty liver disease in 10% to 30% of cases and cannot distinguish steatohepatitis from simple steatosis. Self-reported alcohol intake may cause bias. Because all of the participants were Japanese, generalizability to non-Japanese populations is uncertain.The metabolic syndrome is a strong predictor of nonalcoholic fatty liver disease.
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