Brief Article
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World J Gastroenterol. Apr 7, 2012; 18(13): 1508-1516
Published online Apr 7, 2012. doi: 10.3748/wjg.v18.i13.1508
Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome
Masahide Hamaguchi, Noriyuki Takeda, Takao Kojima, Akihiro Ohbora, Takahiro Kato, Hiroshi Sarui, Michiaki Fukui, Chisato Nagata, Jun Takeda
Masahide Hamaguchi, Immunology Frontier Research Center at Osaka University, Osaka 5650871, Japan
Takao Kojima, Akihiro Ohbora, Takahiro Kato, Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, Gifu 5008523, Japan
Noriyuki Takeda, Hiroshi Sarui, Department of Endocrinology and Metabo lism, Murakami Memorial Hospital, Asahi University, Gifu 5008523, Japan
Michiaki Fukui, Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
Chisato Nagata, Department of Epidemiology and Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu 5008523, Japan
Jun Takeda, Department of Diabetes and Endocrinology, Division of Molecule and Structure, Graduate School of Medicine, Gifu University, Gifu 5008523, Japan
Author contributions: Hamaguchi M and Takeda N designed research; Hamaguchi M, Kojima T, Takeda N, Ohbora A, Kato T, Sarui H, Fukui M, Nagata C and Takeda J performed research; Hamaguchi M analyzed data; and Hamaguchi M and Takeda N wrote the paper.
Supported by Young Scientists (B) (23790791) from Japan Society for the Promotion of Science
Correspondence to: Masahide Hamaguchi, MD, PhD, Immunology Frontier Research Center at Osaka University, Osaka 5650871, Japan. mhamaguchi@frontier.kyoto-u.ac.jp
Telephone: +81-6-68794275 Fax: +81-6-68794272
Received: June 2, 2011
Revised: January 6, 2012
Accepted: January 18, 2012
Published online: April 7, 2012
Abstract

AIM: To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD).

METHODS: Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography. This study involved 11 714 apparently healthy Japanese men and women, 18 to 83 years of age. NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d, known liver disease, or current use of medication. The revised criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.

RESULTS: NAFLD was detected in 32.2% (95% CI: 31.0%-33.5%) of men (n = 1874 of 5811) and in 8.7% (95% CI: 8.0%-9.5%) of women (n = 514 of 5903). Among obese people, the prevalence of NAFLD was as high as 67.3% (95% CI: 64.8%-69.7%) in men and 45.8% (95% CI: 41.7%-50.0%) in women. Although NAFLD was thought of as being the liver phenotype of metabolic syndrome, the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women. 66.8% of men and 70.4% of women with NAFLD were not diagnosed with the metabolic syndrome. 48.2% of men with NAFLD and 49.8% of women with NAFLD weren’t overweight [body mass index (BMI) ≥ 25 kg/m2]. In the same way, 68.6% of men with NAFLD and 37.9% of women with NAFLD weren’t satisfied with abdominal classification (≥ 90 cm for men and ≥ 80 cm for women). Next, authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome. The sensitivity of the definition “at least 1 criterion” was as good as 84.8% in men and 86.6% in women. Separating subjects by BMI, the sensitivity was higher in obese men and women than in non-obese men and women (92.3% vs 76.8% in men, 96.1% vs 77.0% in women, respectively).

CONCLUSION: Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.

Keywords: Nonalcoholic fatty liver, Metabolic syndrome, Population based study, Methodology