Relationships Between Estimates of Adiposity, Insulin Resistance, and Nonalcoholic Fatty Liver Disease in a Large Group of Nondiabetic Korean Adults
- 1 August 2007
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 30 (8), 2113-2118
- https://doi.org/10.2337/dc07-0512
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.This publication has 30 references indexed in Scilit:
- Inflammation and insulin resistanceJCI Insight, 2006
- Clinical model for distinguishing nonalcoholic steatohepatitis from simple steatosis in patients with nonalcoholic fatty liver diseaseLiver International, 2006
- Cutoff Values of Surrogate Measures of Insulin Resistance for Metabolic Syndrome in Korean Non-diabetic AdultsJournal of Korean Medical Science, 2006
- Normal Serum Aminotransferase Levels and the Metabolic Syndrome: Korean National Health and Nutrition Examination SurveysYonsei Medical Journal, 2006
- Is There a Simple Way to Identify Insulin-Resistant Individuals at Increased Risk of Cardiovascular Disease?The American Journal of Cardiology, 2005
- Abnormal glucose tolerance is a predictor of steatohepatitis and fibrosis in patients with non-alcoholic fatty liver diseaseScandinavian Journal of Gastroenterology, 2005
- Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndromeHepatology, 2003
- NASH and insulin resistance: Insulin hypersecretion and specific association with the insulin resistance syndromeHepatology, 2002
- Liver Pathology and the Metabolic Syndrome X in Severe ObesityJournal of Clinical Endocrinology & Metabolism, 1999
- Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR).JCI Insight, 1997