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Relationships between estimates of adiposity, insulin resistance, and nonalcoholic fatty liver disease in a large group of nondiabetic Korean adults.
Diabetes Care. 2007 Aug; 30(8):2113-8.DC

Abstract

OBJECTIVE

Nonalcoholic fatty liver disease (NAFLD) is emerging as a major health problem in parallel with an increasing prevalence of obesity. Insulin resistance and abdominal and overall adiposity are closely associated with NAFLD; however, the interplay between them in the relationship with NAFLD is unclear, especially in nondiabetic individuals.

RESEARCH DESIGN AND METHODS

Abdominal ultrasound, hepatitis serology, and measurements of fasting plasma insulin (FPI), lipid concentrations, overall obesity (BMI), and abdominal obesity (waist circumference) were performed in 56,249 Korean subjects.

RESULTS

After rigorous exclusion criteria, 36,654 nondiabetic subjects (54% male) were enrolled. Subjects were divided into control (no fatty liver on ultrasound, serum alanine aminotransferase [ALT] <30 units/l [men] or <19 units/l [women]), fatty liver with normal ALT (FL-NALT), and fatty liver with a high ALT (FL-HALT) groups. After adjusting for age, BMI, and waist circumference, FPI and ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) were significantly higher in the FL-NALT than in the control group and even higher in the FL-HALT group. Odds ratios for the presence of FL-HALT with increasing quartiles of FPI and TG/HDL-C ratio were increased five- to sevenfold over those of the control group, independent of age, BMI, and waist circumference.

CONCLUSIONS

In this large population of individuals of Korean ancestry, results indicate that while overall (BMI) and abdominal (waist circumference) overweight/obesity are associated with features of NAFLD, surrogate estimates of insulin resistance, FPI concentration, and TG/HDL-C ratio predict NAFLD independently of age, BMI, and waist circumference.

Authors+Show Affiliations

Division of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Pyung Dong, Jongro-Ku, Seoul, Korea 110-746. kcmd.sung@samsung.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17475935

Citation

Sung, Ki Chul, et al. "Relationships Between Estimates of Adiposity, Insulin Resistance, and Nonalcoholic Fatty Liver Disease in a Large Group of Nondiabetic Korean Adults." Diabetes Care, vol. 30, no. 8, 2007, pp. 2113-8.
Sung KC, Ryan MC, Kim BS, et al. Relationships between estimates of adiposity, insulin resistance, and nonalcoholic fatty liver disease in a large group of nondiabetic Korean adults. Diabetes Care. 2007;30(8):2113-8.
Sung, K. C., Ryan, M. C., Kim, B. S., Cho, Y. K., Kim, B. I., & Reaven, G. M. (2007). Relationships between estimates of adiposity, insulin resistance, and nonalcoholic fatty liver disease in a large group of nondiabetic Korean adults. Diabetes Care, 30(8), 2113-8.
Sung KC, et al. Relationships Between Estimates of Adiposity, Insulin Resistance, and Nonalcoholic Fatty Liver Disease in a Large Group of Nondiabetic Korean Adults. Diabetes Care. 2007;30(8):2113-8. PubMed PMID: 17475935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationships between estimates of adiposity, insulin resistance, and nonalcoholic fatty liver disease in a large group of nondiabetic Korean adults. AU - Sung,Ki Chul, AU - Ryan,Marno C, AU - Kim,Bum Soo, AU - Cho,Yong Kyun, AU - Kim,Byung Ik, AU - Reaven,Gerald M, Y1 - 2007/05/02/ PY - 2007/5/4/pubmed PY - 2007/10/5/medline PY - 2007/5/4/entrez SP - 2113 EP - 8 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 8 N2 - OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is emerging as a major health problem in parallel with an increasing prevalence of obesity. Insulin resistance and abdominal and overall adiposity are closely associated with NAFLD; however, the interplay between them in the relationship with NAFLD is unclear, especially in nondiabetic individuals. RESEARCH DESIGN AND METHODS: Abdominal ultrasound, hepatitis serology, and measurements of fasting plasma insulin (FPI), lipid concentrations, overall obesity (BMI), and abdominal obesity (waist circumference) were performed in 56,249 Korean subjects. RESULTS: After rigorous exclusion criteria, 36,654 nondiabetic subjects (54% male) were enrolled. Subjects were divided into control (no fatty liver on ultrasound, serum alanine aminotransferase [ALT] <30 units/l [men] or <19 units/l [women]), fatty liver with normal ALT (FL-NALT), and fatty liver with a high ALT (FL-HALT) groups. After adjusting for age, BMI, and waist circumference, FPI and ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) were significantly higher in the FL-NALT than in the control group and even higher in the FL-HALT group. Odds ratios for the presence of FL-HALT with increasing quartiles of FPI and TG/HDL-C ratio were increased five- to sevenfold over those of the control group, independent of age, BMI, and waist circumference. CONCLUSIONS: In this large population of individuals of Korean ancestry, results indicate that while overall (BMI) and abdominal (waist circumference) overweight/obesity are associated with features of NAFLD, surrogate estimates of insulin resistance, FPI concentration, and TG/HDL-C ratio predict NAFLD independently of age, BMI, and waist circumference. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/17475935/Relationships_between_estimates_of_adiposity_insulin_resistance_and_nonalcoholic_fatty_liver_disease_in_a_large_group_of_nondiabetic_Korean_adults_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=17475935 DB - PRIME DP - Unbound Medicine ER -