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NAFLD is an independent manifestation of the metabolic syndrome

A survey published in this month's Journal of Gastroenterology & Hepatology investigates non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome.

News image

The metabolic syndrome and each of its components are strongly associated with non-alcoholic fatty liver disease.

This has led many investigators to suggest that non-alcoholic fatty liver disease is an independent component of the metabolic syndrome .

Dr Mark Smits and colleagues tested this hypothesis using confirmatory factor analysis, which allows comparison of different models, with or without including non-alcoholic fatty liver disease as a component of the metabolic syndrome .

The researchers analyzed data from 3846 subjects of the Third National Health and Nutrition Examination Survey.

The team of doctors defined non-alcoholic fatty liver disease by increased liver fat measured by ultrasonography.

Metabolic syndrome by Adult Treatment Panel III criteria was present in 21%, and 30% had non-alcoholic fatty liver disease, defined as mild, moderate, or severe ultrasonographic steatosis.

Metabolic syndrome by Adult Treatment Panel III criteria was present in 21%
Journal of Gastroenterology and Hepatology

Using confirmatory factor analysis, a basic model representing the metabolic syndrome using its currently accepted components showed excellent goodness-of-fit statistics.

Addition of non-alcoholic fatty liver disease to the model as a fifth independent variable decreased model fit, suggesting that non-alcoholic fatty liver disease is not an additional independent component of the metabolic syndrome.

Analysis by ethnicity showed that addition of non-alcoholic fatty liver disease decreased model fit in Whites but resulted in minor improvements in non-Hispanic Blacks and Mexican Americans.

Dr Smit's team commented, "The metabolic syndrome is strongly associated with non-alcoholic fatty liver disease."

"However, we found no evidence that non-alcoholic fatty liver disease is an independent component or manifestation of the metabolic syndrome."

"Interestingly, ethnic differences might be important in this relationship and require further study."

J Gastroenterol Hepatol 2013: 28(4): 664-670
16 April 2013

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