Non-alcoholic fatty liver disease and its association with obesity, insulin resistance and increased serum levels of C-reactive protein in Hispanics.
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder of the liver, which may progress to fibrosis or cirrhosis. Recent studies have shown a significant impact of ethnicity on susceptibility to steatosis-related liver disease.


OBJECTIVE
To estimate the prevalence of NAFLD among Chilean Hispanics as well as the clinical and biochemical variables associated with the disease.


METHODS
Population-based study among Chilean Hispanics. The diagnosis of NAFLD was made on the basis of ultrasound evidence of fatty liver and absence of significant alcohol consumption and hepatitis C virus infection.


RESULTS
A total of 832 Hispanic subjects were included. Ultrasound findings revealed diffuse fatty liver in 23% of the subjects. Variables associated with fatty liver in multivariate analysis were body mass index >26.9 [odds ratio (OR) 6.2; 95% confidence interval (CI) 3.3-11.5], abnormal aspartate aminotransferase levels (OR 14; 95% CI 8.2-23.7), presence of insulin resistance as measured by homoeostasis model assessment-insulin resistance (OR 3; 95% CI 1.8-4.8) and serum levels of high-sensitivity C-reactive protein (hs-CRP) greater than 0.86 mg/L (OR 2.9; 95% CI 1.6-5.2). Among subjects with NAFLD, levels of hs-CRP were similar regardless of the alanine aminotransferase (ALT) level.


CONCLUSIONS
Chilean Hispanics exhibit a high prevalence of NAFLD. Obesity, insulin resistance, abnormal aminotransferase levels and elevated hs-CRP were independently associated with the presence of NAFLD. ALT elevation underestimates the presence of ultrasonographical fatty liver, whereas hs-CRP is a sensitive independent marker of NAFLD, which may be useful for detecting fatty liver in the general population.
Riquelme
Arnoldo
A
Departamentos de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. arnoldoriquelme@gmail.com
Arrese
Marco
M
Soza
Alejandro
A
Morales
Arturo
A
Baudrand
René
R
Pérez-Ayuso
Rosa María
RM
González
Robinson
R
Alvarez
Manuel
M
Hernández
Verónica
V
García-Zattera
María José
MJ
Otarola
Francisco
F
Medina
Brenda
B
Rigotti
Attilio
A
Miquel
Juan Francisco
JF
Marshall
Guillermo
G
Nervi
Flavio
F
D001837:Body Weights and Measures; D002097:C-Reactive Protein / Q000032:analysis*; D002677:Chile / Q000453:epidemiology; D005006:Ethnicity; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D016015:Logistic Models; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D014463:Ultrasonography
D002097:C-Reactive Protein