Interaction of obesity, metabolic syndrome and Framingham risk on steatohepatitis among healthy Taiwanese: population-based nested case-control study.
BACKGROUND
There have been scant reports on the cumulative effects of atherosclerotic risk factors on steatohepatitis.


METHODS
We defined cases of steatohepatitis (n = 124) from one health examination center at National Taiwan University Hospital from January to December 2002. We selected controls, matched by age, gender and drinking status. Metabolic syndrome was defined by the modified ATP-III guidelines. High-dimensional interactions of risk factors for steatohepatitis were evaluated.


RESULTS
Steatohepatitis cases had the highest C-reactive protein, lymphocytes, Framingham scores and predicted coronary risks. The odds ratio (OR) of metabolic syndrome for steatohepatitis was the highest (OR = 9.9), followed by high glucose status (OR = 4.5) and obesity (OR = 3.6). The highest area under the ROC curve was metabolic syndrome (area = 0.80), followed by obesity (0.75) and high glucose level (0.73). Metabolic syndrome was the highest population-attributable risk factor (0.59). Significant interaction was found with a three-factor model, including obesity, metabolic syndrome and Framingham risk status, with lesser average prediction error (22.6%), higher average cross-validation consistency (6.3) and lower average prediction error (24.3%). Compared with persons with no risk factors, OR increased as the number of risk factors increased (OR = 3.0 with one risk factor, 17.5 with two risk factors, 10.8 with three risk factors, respectively).


CONCLUSIONS
Metabolic syndrome, inflammation markers and atherosclerotic risk scores are significantly related to steatohepatitis status among the healthy examinee population in Taiwan.
Chien
Kuo-Liong
KL
Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. klchien@ha.mc.ntu.edu.tw
Hsu
Hsiu-Ching
HC
Chao
Chia-Lun
CL
Lee
Bai-Chin
BC
Chen
Ming-Fong
MF
Lee
Yuan-Teh
YT
D000328:Adult; D044466:Asian People; D050197:Atherosclerosis / Q000209:etiology*; D016022:Case-Control Studies; D005234:Fatty Liver / Q000150:complications*; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015233:Models, Statistical; D009765:Obesity / Q000150:complications*; D012307:Risk Factors; D013624:Taiwan