title: Obesity is the only independent factor associated with ultrasound-diagnosed non-alcoholic fatty liver disease: a cross-sectional case-control study.
abstract: OBJECTIVE
  There is increasing interest in ultrasound-diagnosed non-alcoholic fatty liver disease (NAFLD) in the ambulatory care setting. The aim of this study was to determine the clinical and metabolic features of ultrasound-diagnosed NAFLD.
  
  
  METHODS
  Fifty ultrasound-diagnosed NAFLD patients who had not consumed alcohol for at least the previous 3 months were matched with 100 controls by age and gender distribution. Clinical, biochemical, and nutritional variables were compared between the ultrasound-diagnosed NAFLD patients and the controls. Conditional logistic regression analyses were used to identify independent factors associated with ultrasound-diagnosed NAFLD.
  
  
  RESULTS
  The ultrasound-diagnosed NAFLD patients had higher values on the anthropometric measurements than those of the controls. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), uric acid, and gamma-glutamyl transpeptidase levels were higher in the ultrasound-diagnosed NAFLD patients than those in the controls (p<0.001). The ASAT/ALAT ratio of the ultrasound-diagnosed NAFLD patients was lower than that of the controls (p<0.001). Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, non-HDL-cholesterol, atherogenic index, fasting glucose, systolic blood pressure (BP), diastolic BP, and pulse pressure were higher in the ultrasound-diagnosed NAFLD patients than in the control subjects, while lipoprotein(a) was lower. There were no significant differences in low-density lipoprotein (LDL)-cholesterol levels or nutritional intake between patients and controls. Abnormal ASAT or ALAT, hypertriglyceridemia, lower HDL-cholesterol levels, silent myocardial ischemic pattern on electrocardiogram (ECG), impaired fasting glucose, and obesity were common among the ultrasound-diagnosed NAFLD patients. The only independent factor associated with ultrasound-diagnosed NAFLD was obesity (p<0.001).
  
  
  CONCLUSIONS
  Our data suggest that NAFLD diagnosed by ultrasound is associated with hypertriglyceridemia, impaired fasting glucose, silent myocardial ischemic pattern of ECG, obesity, and abnormal liver tests in adults. Among these factors, obesity was the only independent factor associated with ultrasound-diagnosed NAFLD.
authors.affiliation: Family Medicine Division, Center for Obesity Nutrition and Metabolism, Pusan National University Hospital, Seo-gu, Busan, South Korea.
authors.forename: Sangyeoup
authors.initials: S
authors.lastname: Lee
authors.forename: Yun
authors.initials: Y
authors.lastname: Jin Kim
authors.forename: Tae
authors.initials: T
authors.lastname: Yong Jeon
authors.forename: Hyoung
authors.initials: H
authors.lastname: Hoi Kim
authors.forename: Sang
authors.initials: S
authors.lastname: Woo Oh
authors.forename: Yongsoon
authors.initials: Y
authors.lastname: Park
authors.forename: Sung
authors.initials: S
authors.lastname: Soo Kim
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging*; D006160:Guanosine Triphosphate / Q000097:blood; D006801:Humans; D007723:Korea; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D009765:Obesity / Q000097:blood / Q000150:complications*; D016017:Odds Ratio; D014463:Ultrasonography
chemical_list: D008055:Lipids; D006160:Guanosine Triphosphate; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase