title: Insulin resistance and C-reactive protein as independent risk factors for non-alcoholic fatty liver disease in non-obese Asian men.
abstract: OBJECTIVE
  Although insulin resistance is often considered the link between obesity and non-alcoholic fatty liver disease (NAFLD), the role of insulin resistance, independent of obesity, as a NAFLD risk factor in non-obese men has been less well established. Systemic inflammation may be accompanied by insulin resistance in healthy subjects. The goal of the present study was to examine if insulin resistance and systemic inflammatory markers are independent predictors of NAFLD in non-obese men.
  
  
  METHODS
  The authors conducted a cross-sectional survey of 120 patients with NAFLD and 240 controls matched by age and body mass index. Controls had no evidence of alcohol abuse, hepatitis B or C, obesity, or previous history of diabetes, fasting hyperglycemia or hypertension. Diagnosis of NAFLD was based on an elevated alanine aminotransferase level and sonographic evidence of a fatty liver. Insulin resistance was determined using a homeostasis model assessment (HOMA-IR).
  
  
  RESULTS
  The age-adjusted risk of developing NAFLD was strongly associated with the elevated levels in measurements of uric acid, fasting blood sugar, triglycerides, apolipoprotein B, C-reactive protein (CRP) and HOMA-IR, and decreased levels of high density lipoprotein cholesterol and apolipoprotein A-I. Multivariate analysis based on univariate analysis indicated that an increase in CRP (odds ratio [OR] = 1.37; 95% confidence interval [CI]: 1.06-1.77) per 1 SD (1.48 mg/L) and HOMA-IR (OR = 2.28; 95% CI: 1.67-3.11) per 1 SD (0.63) were independent risk factors for NAFLD.
  
  
  CONCLUSIONS
  Insulin resistance and systemic inflammatory response are of key importance for inducing NAFLD, particularly in apparently healthy non-obese men.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Park
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Yun
authors.forename: Jeong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: In Kyung
authors.initials: IK
authors.lastname: Sung
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Park
authors.forename: Chong Il
authors.initials: CI
authors.lastname: Sohn
authors.forename: Woo Kyu
authors.initials: WK
authors.lastname: Jeon
authors.forename: Hyang
authors.initials: H
authors.lastname: Kim
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Rhee
authors.forename: Won Young
authors.initials: WY
authors.lastname: Lee
authors.forename: Sun Woo
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D044466:Asian People; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology*; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008954:Models, Biological; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein