title: Liver enzymes and vitamin D levels in metabolically healthy but obese individuals: Korean National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  Increased liver enzymes and decreased vitamin D levels are associated with insulin resistance and type 2 diabetes. We examined liver enzymes and vitamin D levels in metabolically healthy but obese (MHO) individuals and compared the values with those of other body size phenotypes in the Korean population.
  
  
  METHODS
  A total of 16,190 people over the age of 18years were analyzed using data from the Fourth Korean National Health and Nutrition Examination Survey, which is a nationally representative survey. Body size phenotypes were classified into four groups by body mass index (BMI) and number of metabolic syndrome components.
  
  
  RESULTS
  The prevalence of MHO was 14.9% in the entire population and 47.7% in the obese population. In a correlation analysis adjusted for age, sex, and BMI, AST and ALT levels were positively correlated with insulin resistance and cardiometabolic risk factors of the metabolic syndrome, whereas vitamin D level was negatively correlated with these variables. MHO individuals had significantly lower concentrations of AST and ALT compared to metabolically abnormal obese (MAO) subjects, although vitamin D levels were not significantly different. Furthermore, a multiple logistic regression analysis revealed that MHO individuals had lower risk of liver enzyme abnormality compared to MAO after adjusting for potential confounding factors. However, the risk of vitamin D deficiency was not significantly different among groups with different body size phenotypes.
  
  
  CONCLUSIONS
  Although both liver enzymes and vitamin D levels are related to insulin resistance and metabolic syndrome, only liver enzymes were independently associated with MHO phenotype.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors: Ho Cheol
authors: HC
authors: Hong
authors: Ji-Sung
authors: JS
authors: Lee
authors: Hae Yoon
authors: HY
authors: Choi
authors: Sae Jeong
authors: SJ
authors: Yang
authors: Hye Jin
authors: HJ
authors: Yoo
authors: Ji A
authors: JA
authors: Seo
authors: Sin Gon
authors: SG
authors: Kim
authors: Nan Hee
authors: NH
authors: Kim
authors: Sei Hyun
authors: SH
authors: Baik
authors: Dong Seop
authors: DS
authors: Choi
authors: Kyung Mook
authors: KM
authors: Choi
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007723:Korea; D008099:Liver / Q000201:enzymology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000378:metabolism*; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: 25(OH)D; 25-hydroxyvitamin D; BMI; Body mass index; Body size phenotype; CI; CVD; Cardiovascular disease; Confidence interval; Fourth Korean National Health and Nutrition Examination Survey; KNHANES IV; MAO; MHO; Metabolically abnormal obese; Metabolically healthy but obese; NAFLD; NHANES III; Nonalcoholic fatty liver disease; OR; Obesity metabolism; Odds ratio; Third National Health and Nutrition Examination Survey in the United States; Vitamin D