title: Relationship between obesity, metabolic syndrome, and nonalcoholic fatty liver disease in the elderly agricultural and fishing population of Taiwan.
abstract: BACKGROUND
  The purpose of this study was to explore the relationship between obesity, the metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) in the elderly agricultural and fishing population of Taipei, Taiwan.
  
  
  METHODS
  The study participants comprised 6,511 (3,971 male and 2,540 female) healthy elderly subjects voluntarily attending a teaching hospital for a physical check-up in 2010. Blood samples and real-time ultrasound-proven fatty liver sonography results were collected.
  
  
  RESULTS
  The prevalence of NAFLD in this elderly population was 27.2%, including mild NAFLD (16.0%), moderate NAFLD (10.3%), and severe NAFLD (0.9%). The prevalence of moderate or severe NAFLD for metabolic syndrome proved to be substantially greater (P<0.0001, χ(2) test) for one or two metabolic factors. Using multinomial logistic regression analysis, age, sex, metabolic syndrome, and higher body mass index had a statistically significant association with mild NAFLD. Age, sex, metabolic syndrome, higher body mass index, and higher alanine aminotransferase were significantly related to moderate NAFLD. In addition, higher body mass index, higher uric acid, and higher alanine aminotransferase levels were significantly related to severe NAFLD. The sensitivity and specificity of body mass index and waist circumference as markers of NAFLD were estimated to be 81% and 84%, respectively, and 77% and 69%, respectively.
  
  
  CONCLUSIONS
  The prevalence of mild or moderate NAFLD was related to obesity and metabolic syndrome. Higher body mass index was also related to severe NAFLD but not to metabolic syndrome. Targeting this population for control of obesity and improved metabolic function is important.
authors.affiliation: Department of Surgery, New Taipei City Hospital, Taipei, Taiwan ; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan ; Department of Healthcare Management, Yuanpei University, Hsinchu, Taiwan.
authors.forename: Hsi-Che
authors.initials: HC
authors.lastname: Shen
authors.affiliation: Faculty of Public Health, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Zi-Hao
authors.initials: ZH
authors.lastname: Zhao
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan ; Oriental Institute of Technology, Taipei, Taiwan ; Department of Nursing, New Taipei City Hospital, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Hu
authors.affiliation: Business Place Hygiene Management, Department of Health, Taipei City Government, Taiwan ; Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan ; Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan.
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Faculty of Public Health, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan ; Department of Medical Research and Education, Cheng-Hsin General Hospital, Taipei, Taiwan ; Department of Crime Prevention and Correction, Central Police University, Taoyuan, Taiwan.
authors.forename: Tao-Hsin
authors.initials: TH
authors.lastname: Tung
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D015992:Body Mass Index; D005260:Female; D005398:Fisheries; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography; D055105:Waist Circumference
keywords: agriculture; elderly; fishing; metabolic syndrome; nonalcoholic fatty liver disease
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