title: Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area.
abstract: BACKGROUND
  The aim of this study was to evaluate the distribution of fatty liver-nonalcoholic (NAFL) and alcoholic (AFL)-and its association with metabolic syndrome and its components in a population sample from a Mediterranean area.
  
  
  METHODS
  A sample of 2974 subjects (1679 males, 1295 females, age range 30-89 years) was randomly drawn from the population of a town in southern Italy. The survey visit included a validated semiquantitative food frequency questionnaire, anthropometric measurements, a blood sample taken in the morning after overnight fasting, as well as abdominal ultrasound examination to evaluate liver fat with a standardized scoring system. The 2001 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition of the metabolic syndrome was adopted.
  
  
  RESULTS
  In this Mediterranean population, where alcohol intake is mostly as wine with meals, NAFL is present in 36.8% of men and 25.7% of women and AFL in 13.8% of men and 5.5% of women. NAFL and AFL are associated with metabolic syndrome and its characteristics, body mass index (BMI), and visceral and subcutaneous fat (in AFL subjects, only in women) measured by ultrasound. Stratifying by BMI and controlling for confounders (age, height, smoking habit, and alcohol consumption), in overweight and obese subjects, liver and visceral fat are associated with the metabolic syndrome both in men and women and subcutaneous fat only in women. In normal weight subjects, only liver fat in men is associated with the metabolic syndrome.
  
  
  CONCLUSIONS
  Fatty liver is highly prevalent in this Mediterranean population and is associated with metabolic syndrome in overweight and obese men and women as well as in men with normal BMI.
authors.affiliation: 1 Radiology Unit, National Institute for Digestive Disease , IRCCS "S. de Bellis," Castellana, Bari, Italy .
authors.forename: Marisa
authors.initials: M
authors.lastname: Chiloiro
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Caruso
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Cisternino
authors.forename: Rosa
authors.initials: R
authors.lastname: Inguaggiato
authors.forename: Rosa
authors.initials: R
authors.lastname: Reddavide
authors.forename: Caterina
authors.initials: C
authors.lastname: Bonfiglio
authors.forename: Vito
authors.initials: V
authors.lastname: Guerra
authors.forename: Maria
authors.initials: M
authors.lastname: Notarnicola
authors.forename: Giampietro
authors.initials: G
authors.lastname: De Michele
authors.forename: Mario
authors.initials: M
authors.lastname: Correale
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Noviello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Misciagna
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D000886:Anthropometry; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005235:Fatty Liver, Alcoholic / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008099:Liver / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D012737:Sex Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D014463:Ultrasonography