Non-alcoholic and alcoholic fatty liver disease - two diseases of affluence associated with the metabolic syndrome and type 2 diabetes: the FIN-D2D survey.
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) is known to be associated with the metabolic syndrome (MetS) and abnormal glucose tolerance. Whether alcoholic fatty liver disease (AFLD) is associated with similar metabolic abnormalities has not been examined in a population-based study. We aimed at assessing the prevalences of NAFLD and AFLD, and to examine to what extent these conditions are associated with MetS and abnormal glucose tolerance.


METHODS
The cohort included 2766 Finnish subjects (45-74 years) from the population-based FIN-D2D survey. Features of insulin resistance, components of the MetS, glucose tolerance status by oral glucose tolerance test, serum liver enzyme concentrations, and daily alcohol consumption were assessed.


RESULTS
Subjects with NAFLD and AFLD were equally obese and had similar fasting and insulin concentrations. The prevalences of NAFLD and AFLD were 21% (95% CI: 19%-22%) and 7% (95% CI: 6%-8%). The MetS was slightly more prevalent in AFLD (73%) than in NAFLD (70%, p = 0.028), and type 2 diabetes was similarly prevalent in NAFLD and AFLD (24-25%). The MetS and type 2 diabetes were more prevalent in subjects with NAFLD or AFLD compared to subjects with normal LFTs (53% and 14%, p < 0.0001 for both).


CONCLUSIONS
In Finnish middle-aged population, the prevalence of NAFLD is 3-fold higher than that of AFLD. The prevalences of MetS and type 2 diabetes are, however, significantly increased in both NAFLD and AFLD compared to subjects with normal LFTs. Subjects with AFLD are thus similarly metabolically unhealthy as subjects with NAFLD.
Kotronen
Anna
A
Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. anna.kotronen@helsinki.fi
Yki-Järvinen
Hannele
H
Männistö
Satu
S
Saarikoski
Liisa
L
Korpi-Hyövälti
Eeva
E
Oksa
Heikki
H
Saltevo
Juha
J
Saaristo
Timo
T
Sundvall
Jouko
J
Tuomilehto
Jaakko
J
Peltonen
Markku
M
D000328:Adult; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005234:Fatty Liver / Q000453:epidemiology* / Q000378:metabolism; D005235:Fatty Liver, Alcoholic / Q000453:epidemiology; D005260:Female; D005387:Finland; D018149:Glucose Intolerance / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence
Ann Intern Med. 2002 Jul 2;137(1):1-10
12093239
Lancet. 2005 Sep 24-30;366(9491):1059-62
16182882
Horm Metab Res. 2005 Apr;37(4):246-51
15952086
Am J Gastroenterol. 2005 Apr;100(4):850-5
15784031
Atherosclerosis. 1986 Apr;60(1):79-87
3707675
Hepatogastroenterology. 2003 Nov-Dec;50(54):2101-4
14696473
Best Pract Res Clin Gastroenterol. 2004 Dec;18(6):1089-104
15561640
Hepatology. 2007 Apr;45(4):846-54
17393509
Am J Gastroenterol. 1999 Apr;94(4):1018-22
10201476
Am J Physiol Endocrinol Metab. 2005 Feb;288(2):E462-8
15339742
QJM. 1996 Feb;89(2):137-44
8729555
J Clin Endocrinol Metab. 2007 Sep;92(9):3490-7
17595248
Arterioscler Thromb Vasc Biol. 2008 Jan;28(1):27-38
17690317
Clin Chem. 1972 Jun;18(6):499-502
4337382
J Clin Endocrinol Metab. 2005 Jun;90(6):3498-504
15797948
Gastroenterology. 1999 Jun;116(6):1413-9
10348825
BMC Public Health. 2008 Dec 29;8:423
19113993
Int J Circumpolar Health. 2007 Apr;66(2):101-12
17515250
Hepatology. 2003 May;37(5):1202-19
12717402
J Clin Epidemiol. 1988;41(2):105-14
3335877
Arterioscler Thromb Vasc Biol. 2008 Apr;28(4):629-36
18174459
J Hum Hypertens. 1991 Apr;5(2):59-67
1677046
Am J Gastroenterol. 2003 May;98(5):960-7
12809815
J Clin Gastroenterol. 2006 Mar;40 Suppl 1:S5-10
16540768
Gut. 2004 May;53(5):750-5
15082596
Proc Soc Exp Biol Med. 1984 Sep;176(4):508-11
6463061
J Clin Gastroenterol. 2003 Nov-Dec;37(5):399-402
14564188
Hepatology. 2005 Jul;42(1):44-52
15895401