title: Relation of nonalcoholic fatty liver disease to the metabolic syndrome: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  An overlap exists between risk factors for metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD).
  
  
  OBJECTIVE
  We studied the association of MetS and its components with NAFLD in a multi-ethnic population.
  
  
  METHODS
  Cross-sectional study was designed, including 6814 participants from the Multi-Ethnic Study of Atherosclerosis. Liver fat content was measured with cardiac CT scans by using liver-to-spleen ratio of <1.0 and liver attenuation < 40 HU. Participants with heavy alcohol intake (>14 drinks/week for men and >7 drinks/week for women), self-reported history of cirrhosis, and missing information were excluded. A total of 4140 participants met the criteria for inclusion in the study.
  
  
  RESULTS
  The odds ratios (ORs) for presence of NAFLD were highest for persons with diabetes (OR, 4.16; 95% CI, 3.24-5.33), followed by presence of MetS (OR, 3.97; 95% CI, 3.26-4.83). Among components of MetS central obesity was associated with higher odds for presence (OR, 3.41; 95% CI, 2.77-4.20) and severity (OR, 5.58; 95% CI, 3.86-8.06) of NAFLD . The ORs for moderate-to-severe NAFLD were higher for presence of MetS (OR, 5.92; 95% CI, 4.29-8.19)] by using <40 HU as the cutoff. However, odds of NAFLD increased significantly for combination of MetS components: 9.49 (95% CI, 5.67-15.90) and 24.05 (95% CI, 12.73-45.45) for presence of 3 and 5 MetS components, respectively.
  
  
  CONCLUSIONS
  Components of MetS are associated with increased odds for presence and severity of NAFLD and increased risk with increasing number of MetS components in a multi-ethnic population of middle-to-old age persons.
authors.affiliation: Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 10457, USA. Electronic address: izeb82@gmail.com.
authors.forename: Irfan
authors.initials: I
authors.lastname: Zeb
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.forename: Panteha
authors.initials: P
authors.lastname: Rezaeian
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D050154:Adiposity; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology; D005234:Fatty Liver / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000208:ethnology*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D065626:Non-alcoholic Fatty Liver Disease; D056128:Obesity, Abdominal / Q000208:ethnology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging; D014481:United States / Q000453:epidemiology
keywords: Fatty liver; MESA; Metabolic syndrome