Metabolic syndrome is related to nonalcoholic steatohepatitis in severely obese subjects.
BACKGROUND
Metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD), ranging from simple steatosis to steatohepatitis (NASH), have become important health issues in obese subjects. In this study, we investigated the relationship between MetS and NASH in severely obese subjects.


METHODS
A total of 111 non-alcoholic obese patients who underwent laparoscopic bariatric surgery (BMI 45.4 +/- 5.7 kg/m2) were enrolled from February to September 2004 in a referral center in North Taiwan. MetS and its individual components were defined using the American Heart Association/National Heart, Lung, and Blood Institute criteria. Based on liver biopsy during surgery, subjects were classified into either having NASH or not. The relationship among NASH, adiponectin, insulin resistance, MetS and its individual components was examined using a multivariate logistic regression analysis.


RESULTS
The prevalence of NASH and MetS in these subjects was 79.3% and 68.5%, respectively. Using a multivariate logistic regression analysis with NASH as the outcome variable, odds ratio (OR) of NASH for subjects with MetS versus without MetS was 2.96 (95% CI = 1.14-7.68) adjusted for age, gender, and BMI. Also, high blood pressure (OR = 2.97, 1.31-6.73) and high fasting glucose (OR = 2.94, 1.13-7.67) were independently associated with NASH after adjustment for age, gender, and BMI. Insulin resistance measured as HOMA-IR and serum adiponectin level were not significantly different between the NASH and non-NASH group.


CONCLUSIONS
MetS and NASH were common in severely obese Taiwanese adults. Presence of MetS, high blood pressure, and high fasting glucose was independently related to increased risk of NASH. The underlying mechanism deserves to be explored in the future.
Huang
Hsien-Liang
HL
Department of Family Medicine, National Taiwan University Hospital, Taipei.
Lin
Wen-Yuan
WY
Lee
Long-Teng
LT
Wang
Hsih-Hsi
HH
Lee
Wei-Jei
WJ
Huang
Kuo-Chin
KC
D052242:Adiponectin / Q000097:blood; D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D010535:Laparoscopy; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013624:Taiwan
D052242:Adiponectin