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Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome.
Hepatology. 2003 Apr; 37(4):917-23.Hep

Abstract

Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin-resistance syndrome, at present defined as the metabolic syndrome, whose limits were recently set. We assessed the prevalence of the metabolic syndrome in 304 consecutive NAFLD patients without overt diabetes, on the basis of 3 or more criteria out of 5 defined by the U.S. National Institutes of Health (waist circumference, glucose, high-density lipoprotein [HDL]-cholesterol, triglycerides, and arterial pressure). The prevalence of the metabolic syndrome increased with increasing body mass index, from 18% in normal-weight subjects to 67% in obesity. Insulin resistance (Homeostasis Model Assessment method) was significantly associated with the metabolic syndrome (odds ratio [OR], 2.5; 95% CI, 1.5-4.2; P <.001). Liver biopsy was available in 163 cases (54%). A total of 120 patients (73.6%) were classified as having nonalcoholic steatohepatitis (NASH); 88% of them had a metabolic syndrome (vs. 53% of patients with pure fatty liver; P <.0001). Logistic regression analysis confirmed that the presence of metabolic syndrome carried a high risk of NASH among NAFLD subjects (OR, 3.2; 95% CI, 1.2-8.9; P =.026) after correction for sex, age, and body mass. In particular, the syndrome was associated with a high risk of severe fibrosis (OR, 3.5; 95% CI, 1.1-11.2; P =.032). In conclusion, the presence of multiple metabolic disorders is associated with a potentially progressive, severe liver disease. The increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension, and ultimately the metabolic syndrome puts a very large population at risk of forthcoming liver failure in the next decades.

Authors+Show Affiliations

Unit of Metabolic Diseases and Department of Internal Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy. marchreg@med.unibo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12668987

Citation

Marchesini, Giulio, et al. "Nonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome." Hepatology (Baltimore, Md.), vol. 37, no. 4, 2003, pp. 917-23.
Marchesini G, Bugianesi E, Forlani G, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003;37(4):917-23.
Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., & Rizzetto, M. (2003). Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology (Baltimore, Md.), 37(4), 917-23.
Marchesini G, et al. Nonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome. Hepatology. 2003;37(4):917-23. PubMed PMID: 12668987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. AU - Marchesini,Giulio, AU - Bugianesi,Elisabetta, AU - Forlani,Gabriele, AU - Cerrelli,Fernanda, AU - Lenzi,Marco, AU - Manini,Rita, AU - Natale,Stefania, AU - Vanni,Ester, AU - Villanova,Nicola, AU - Melchionda,Nazario, AU - Rizzetto,Mario, PY - 2003/4/2/pubmed PY - 2003/4/24/medline PY - 2003/4/2/entrez SP - 917 EP - 23 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 37 IS - 4 N2 - Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin-resistance syndrome, at present defined as the metabolic syndrome, whose limits were recently set. We assessed the prevalence of the metabolic syndrome in 304 consecutive NAFLD patients without overt diabetes, on the basis of 3 or more criteria out of 5 defined by the U.S. National Institutes of Health (waist circumference, glucose, high-density lipoprotein [HDL]-cholesterol, triglycerides, and arterial pressure). The prevalence of the metabolic syndrome increased with increasing body mass index, from 18% in normal-weight subjects to 67% in obesity. Insulin resistance (Homeostasis Model Assessment method) was significantly associated with the metabolic syndrome (odds ratio [OR], 2.5; 95% CI, 1.5-4.2; P <.001). Liver biopsy was available in 163 cases (54%). A total of 120 patients (73.6%) were classified as having nonalcoholic steatohepatitis (NASH); 88% of them had a metabolic syndrome (vs. 53% of patients with pure fatty liver; P <.0001). Logistic regression analysis confirmed that the presence of metabolic syndrome carried a high risk of NASH among NAFLD subjects (OR, 3.2; 95% CI, 1.2-8.9; P =.026) after correction for sex, age, and body mass. In particular, the syndrome was associated with a high risk of severe fibrosis (OR, 3.5; 95% CI, 1.1-11.2; P =.032). In conclusion, the presence of multiple metabolic disorders is associated with a potentially progressive, severe liver disease. The increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension, and ultimately the metabolic syndrome puts a very large population at risk of forthcoming liver failure in the next decades. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/12668987/Nonalcoholic_fatty_liver_steatohepatitis_and_the_metabolic_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270913903001216 DB - PRIME DP - Unbound Medicine ER -