title: Association of nonalcoholic fatty liver disease with components of metabolic syndrome according to body mass index in Korean adults.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, and its prevalence is much higher in obese individuals. NAFLD is closely related to metabolic syndrome (MetS); however, most concepts about the relationship between NAFLD and MetS have emphasized obesity, although NAFLD is not a rare disease in the non-obese population. In the present study, we aim to determine the association between NAFLD and MetS and to compare this association between non-obese and obese individuals.
  
  
  METHODS
  A total of 29,994 adults who underwent routine comprehensive health evaluations, including abdominal ultrasonography, were selected. We calculated the adjusted prevalence ratios (PRs) for components of MetS (high blood pressure (BP), impaired fasting glucose, low high-density lipoprotein cholesterol (HDL-C), and high triglycerides (TG)) according to NAFLD in non-obese and obese patients.
  
  
  RESULTS
  NAFLD was found in 12.6% of non-obese subjects and 50.1% of obese subjects. NAFLD was associated with most components of MetS in both obese and non-obese subjects. However, non-obese NAFLD patients had significantly higher PRs for certain components of MetS than did obese patients, especially among women. Adjusted PRs (95% confidence interval) for components of MetS in non-obese women vs. obese women were as follows: (1) high BP: 1.41 (1.31-1.51) vs. 1.05 (0.89-1.22) (2) impaired fasting glucose: 2.04 (1.95-2.75) vs. 1.37 (1.21-1.53) (3) low HDL-C: 2.00 (1.92-2.08) vs. 1.40 (1.26-1.55), and (4) high TG: 3.36 (3.24-3.47) vs. 1.97 (1.76-2.17).
  
  
  CONCLUSIONS
  NAFLD was associated with risk for components of MetS, and the association was stronger in non-obese than in obese individuals, especially in women. Therefore, NAFLD should be considered a meaningful predictor of metabolic diseases in the non-obese population.
authors.affiliation: Department of Family Medicine, SamYook Medical Center, Seoul, Republic of Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kwon
authors.forename: Seung-Won
authors.initials: SW
authors.lastname: Oh
authors.forename: Seung-sik
authors.initials: SS
authors.lastname: Hwang
authors.forename: CheolMin
authors.initials: C
authors.lastname: Lee
authors.forename: Hyuktae
authors.initials: H
authors.lastname: Kwon
authors.forename: Goh Eun
authors.initials: GE
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides