The frequent association of nonalcoholic fatty liver disease with components of the metabolic syndrome is well known.
Components of the metabolic syndrome include obesity, hyperglycemia, dyslipidemia, and hypertension.
However, no prospective study has examined the role of the metabolic syndrome in the development of this disease.
Dr Masahide Hamaguchi and colleagues from Japan characterized the relationship between the metabolic syndrome and nonalcoholic fatty liver disease.
The investigators conducted a prospective observational study by obtaining data from a medical health checkup program in a general hospital.
The team included 4401 apparently healthy Japanese men and women, from 21 to 80 years of age, with a mean body mass index of 23 kg/m2.
|Nonalcoholic fatty liver disease regression occurred in 16% with metabolic syndrome at baseline|
|Annals of Internal Medicine|
Alcohol intake was assessed by using a questionnaire.
The investigators obtained biochemical tests for liver and metabolic function and abdominal ultrasonography.
Modified criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.
At baseline, 18% participants had nonalcoholic fatty liver disease.
During the mean follow-up period of 414 days, the investigators observed 308 new cases of nonalcoholic fatty liver disease among 3147 participants.
These participants were disease-free at baseline and who completed a second examination.
The team observed regression of nonalcoholic fatty liver disease in 16% of participants who had the disease at baseline and completed a second examination.
Men and women who met the criteria for the metabolic syndrome at baseline were more likely to develop the disease during follow-up.
The investigators found that nonalcoholic fatty liver disease was less likely to regress in those participants with the metabolic syndrome at baseline.
The team reported that ultrasonography may lead to an incorrect diagnosis of nonalcoholic fatty liver disease in 10% to 30% of cases.
Also the investigators noted that ultrasonography cannot distinguish steatohepatitis from simple steatosis.
Self-reported alcohol intake may cause bias, and the generalizability to non-Japanese populations is uncertain.
Dr Hamaguchi's team concluded, “The metabolic syndrome is a strong predictor of nonalcoholic fatty liver disease.”