Severity of ultrasonographic liver steatosis and metabolic syndrome in Korean men and women

Table 1 Clinical and biochemical characteristics of 557 men and 465 women with different severities of ultrasonographic liver steatosis

Characteristics	Ultrasonographic liver steatosis
	Men				P for trend	Women					P for trend
	Absent	Mild	Moderate	Severe		Absent	Mild	Moderate	Severe
	(n = 240)	(n = 133)	(n = 165)	(n = 19)		(n = 275)	(n = 87)	(n = 93)	(n = 10)
Age (yr)	51.6 ± 11.0	50.0 ± 9.9	51.4 ± 10.6	49.2 ± 11.2	0.521	51.5 ± 9.4	52.7 ± 9.5	55.5 ± 7.8	55.9 ± 9.1		< 0.001
Body mass index (kg/m2)	23.1 ± 2.5	24.7 ± 2.3	25.3 ± 2.6	26.5 ± 2.1	< 0.001	23.6 ± 2.7	25.8 ± 3.1	26.6 ± 3.0	27.5 ± 4.0		< 0.001
Waist circumference (cm)	83.0 ± 6.9	88.0 ± 6.5	89.2 ± 6.3	92.1 ± 6.8	< 0.001	79.0 ± 7.0	85.2 ± 7.7	88.0 ± 7.4	88.5 ± 8.5		< 0.001
Body fat percent	20.0 ± 4.4	23.0 ± 4.2	23.4 ± 4.1	24.1 ± 3.5	< 0.001	30.1 ± 4.7	33.2 ± 5.4	34.8 ± 4.9	36.1 ± 3.8		< 0.001
Systolic BP (mmHg)	126.7 ± 16.9	129.4 ± 16.0	133.9 ± 18.8	133.7 ± 10.7	< 0.001	128.4 ± 20.2	131.7 ± 17.3	136.5 ± 19.1	138.5 ± 10.6		< 0.001
Diastolic BP (mmHg)	78.2 ± 11.5	79.9 ± 11.1	83.0 ± 12.2	84.2 ± 7.9	< 0.001	78.2 ± 13.2	80.7 ± 12.0	82.7 ± 11.9	82.0 ± 7.9		0.002
Total cholesterol	194.5 ± 32.2	200.6 ± 33.4	205.3 ± 34.6	204.7 ± 25.1	0.001	201.3 ± 33.0	208.3 ± 37.3	217.0 ± 36.9	225.4 ± 28.2		< 0.001
(mg/dL)
Triglyceride (mg/dL)	149.4 ± 104.9	200.2 ± 119.5	230.1 ± 161.8	230.6 ± 111.7	< 0.001	123.5 ± 93.1	164.5 ± 115.3	188.6 ± 122.0	184.0 ± 80.1		< 0.001
HDL-cholesterol	46.2 ± 10.4	43.7 ± 9.6	41.3 ± 8.3	41.7 ± 8.8	< 0.001	52.9 ± 13.4	47.3 ± 12.8	47.0 ± 12.1	47.0 ± 7.6		< 0.001
(mg/dL)
Fasting glucose	97.5 ± 23.3	101.7 ± 19.6	108.3 ± 29.4	117.2 ± 36.0	< 0.001	92.7 ± 21.2	102.9 ± 36.3	103.4 ± 27.4	109.7 ± 17.7		< 0.001
(mg/dL)
Fasting insulin (IU/L)	9.8 ± 11.4	11.9 ± 6.9	12.6 ± 7.1	13.2 ± 5.1	0.002	9.1 ± 4.9	13.9 ± 8.6	15.1 ± 9.7	16.9 ± 6.2		< 0.001
HOMA-IR	2.6 ± 5.4	3.0 ± 1.9	3.3 ± 2.0	3.9 ± 1.8	0.037	2.1 ± 1.4	3.5 ± 2.3	3.8 ± 2.5	4.5 ± 1.5		< 0.001
AST (IU/L)	22.4 ± 7.2	25.0 ± 10.0	27.5 ± 21.5	29.5 ± 8.0	< 0.001	21.0 ± 7.8	21.4 ± 11.3	23.0 ± 11.2	28.2 ± 6.3		0.013
ALT (IU/L)	23.4 ± 11.8	31.5 ± 18.3	38.3 ± 35.9	50.8 ± 19.0	< 0.001	19.2 ± 13.5	21.8 ± 13.8	26.8 ± 17.4	34.8 ± 12.9		< 0.001
γ-GT (IU/L)	45.1 ± 50.6	67.1 ± 63.4	69.4 ± 148.8	69.4 ± 42.6	0.009	23.7 ± 22.8	31.6 ± 37.7	32.8 ± 21.3	38.7 ± 11.1		< 0.001
Carotid IMT (mm)	0.71 ± 0.19	0.75 ± 0.21	0.79 ± 0.26	0.73 ± 0.13	< 0.001	0.70 ± 0.21	0.77 ± 0.23	0.79 ± 0.23	0.81 ± 0.31		< 0.001
Menopause (%)						58.2	60.9	81.5	90		< 0.001
Current smoking	47.9	46.6	42.4	42.1	0.269	5.1	5.8	1.1	10		0.345
Alcohol intake ≥ 4/wk	55.6	60.9	53	42.1	0.387	13.2	17.2	9.7	-		0.314
Carotid IMT 1.0 ≥ (mm)	10	10.5	17	5.3	0.143	6.6	12.6	8.6	20		0.145

Table 2 Sex-specific prevalence of metabolic disorders by the severity of ultrasonographic liver steatosis

	Severity of ultrasonographic liver steatosis				P
	Absent	Mild	Moderate	Severe
Men (%)	(n = 240)	(n = 133)	(n = 165)	(n = 19)
Waist circumference > 90 (cm)	14.6	33.1	44.2	57.9	< 0.001
Blood pressure ≥ 130/85 (mmHg)1	51.7	52.6	72.1	84.2	< 0.001
Fasting glucose ≥ 110 (mg/dL)2	11.3	12	21.8	15.8	0.008
Triglyceride ≥ 150 (mg/dL)	33.8	63.2	67.3	73.7	< 0.001
HDL-cholesterol < 40 (mg/dL)	30.4	39.8	42.4	36.8	0.02
Metabolic syndrome (≥ 3 of the above)	16.3	31.6	46.7	57.9	< 0.001
Number of metabolic	1.4 ± 1.1	2.0 ± 1.2	2.5 ± 1.1	2.7 ± 1.1	< 0.001
abnormalities, mean±SD
Women (%)	(n = 275)	(n = 87)	(n = 93)	(n = 10)
Waist circumference > 80 (cm)	42.9	81.6	87.1	90	< 0.001
Blood pressure ≥ 130/85 (mmHg)1	56.4	64.4	73.1	100	< 0.001
Fasting glucose ≥ 110 (mg/dL)2	2.2	14.9	16.1	40	< 0.001
Triglyceride ≥ 150 (mg/dL)	22.9	34.5	47.3	60	< 0.001
HDL-cholesterol < 50 (mg/dL)	41.8	62.1	62.4	70	< 0.001
Metabolic syndrome (≥ 3 of the above)	22.5	54	65.6	70	< 0.001
Number of metabolic	1.7 ± 1.1	2.6 ± 1.1	2.9 ± 1.1	3.6 ± 1.3	< 0.001
abnormalities, mean±SD

HDL: high density lipoprotein.

¹Including subjects taking anti-hypertensive medication.

²Including subjects taking anti-diabetic medication.

Table 3 Sex-specific associations between the severity of ultrasonographic liver steatosis and metabolic syndrome

Ultrasoundliver steatosis	Numberof people	Number withmetabolic syndrome (%)	Age-adjustedodds ratio (95%CI)	Multivariate-adjustedodds ratio (95%CI)1
Men
Absent	240	39 (16.3)	1.00	1.00
Mild	133	42 (31.6)	2.43 (1.47-4.01)	1.72 (1.01-2.94)
Moderate	165	77 (46.7)	4.54 (2.87-7.20)	2.89 (1.75-4.76)
Severe	19	11 (57.9)	7.32 (2.76-19.44)	3.53 (1.25-9.98)
Total	557	169 (30.3)	P < 0.001	P < 0.001
Women
Absent	275	62 (22.6)	1.00	1.00
Mild	87	47 (54.0)	4.06 (2.41-6.83)	2.86 (1.64-5.01)
Moderate	93	61 (65.6)	5.81 (3.45-9.80)	3.19 (1.80-5.65)
Severe	10	7 (70.0)	7.07 (1.73-28.89)	3.70 (0.82-16.73)
Total	465	177 (38.1)	P < 0.001	P < 0.001

¹Adjusted for age, menopause (in women), body mass index, cigarette smoking, and alcohol intake.

Table 4 Sex-specific associations between liver enzyme levels and metabolic syndrome

	AST (IU/L)	Multivariate-adjustedodds ratio (95%CI)1	ALT (IU/L)	Multivariate-adjustedodds ratio (95%CI)1	γ-GT (IU/L)	Multivariate-adjustedodds ratio (95%CI)1
Men
	9-21	1.00	4-22	1.00	9-35	1.00
	22-25	0.69 (0.42-1.16)	23-31	1.76 (1.04-2.99)	36-52	1.66 (0.95-2.90)
	26-46	0.89 (0.54-1.45)	32-77	2.57 (1.54-4.29)	53-180	3.20 (1.87-5.47)
	47-278	1.81 (0.62-5.28)	78-421	5.23 (1.69-16.18)	181-1 885	3.33 (1.09-10.16)
		P = 0.953		P < 0.001		P < 0.001
Women
	9-21	1.00	4-19	1.00	8-22	1.00
	22-24	0.58 (0.32-1.06)	20-24	1.22 (0.70-2.12)	23-31	1.87 (1.06-3.30)
	25-42	0.96 (0.54-1.70)	25-61	1.44 (0.83-2.50)	32-100	1.25 (0.72-2.19)
	43-117	0.68 (0.16-2.93)	62-172	0.87 (0.20-3.73)	101-323	1.46 (0.33-6.37)
		P = 0.475		P = 0.271		P = 0.230

AST: aspartate aminotransferase; ALT: alanine aminotransferase; γ-GT: γ-glutamyl transferase.

¹Adjusted for age, menopause (in women), body mass index, cigarette smoking, and alcohol intake.