title: Prediction of metabolic syndrome by non-alcoholic fatty liver disease in northern urban Han Chinese population: a prospective cohort study.
abstract: OBJECTIVE
  To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS), and evaluate the value of NAFLD as a marker for predicting the risk of MetS in a large scale prospective cohort from northern urban Han Chinese population.
  
  
  METHODS
  A total of 17,920 MetS-free at baseline cohort members was included in the current study between 2005 and 2011. The baseline characteristics of the cohort were compared by NAFLD status at baseline, MetS status after follow-up. Cox proportional hazards models were used to estimate the unadjusted or adjusted hazard ratios (HRs) for NAFLD at baseline predicting the risk of MetS.
  
  
  RESULTS
  2,183 (12.18%) new cases of MetS occurred between 2005 and 2011. In unadjusted model, HRs (95% CIs) for NAFLD predicting MetS was 3.65 (3.35, 3.97). After adjusting the confounding factors of age, gender, the metabolic factors, smoke and exercise, the HRs (95% CIs) was 1.70 (1.55, 1.87). Gender difference was observed, adjusted HRs (95% CIs) of NAFLD for predicting MetS were 2.06(1.72, 2.46) and 1.55(1.39, 1.72) in female and male population, respectively. Moreover, 163 participants developed MetS among participants without any MetS component at baseline, and its adjusted HRs was still significant, 1.87 (1.12, 3.13).
  
  
  CONCLUSIONS
  The present study indicates that NAFLD is an independent risk factor for predicting the risk of MetS in northern urban Han Chinese population, and the people with NAFLD should initiate weight and dietary control to prevent the occurrence of MetS.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Medical Department,Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Yongyuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China.
authors.forename: Chengqi
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Tang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Hongkai
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Center for Health Management, Provincial Hospital affiliated to Shandong University, Jinan, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Lin
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Yanxun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
mesh_terms: D000328:Adult; D000367:Age Factors; D044466:Asian People; D002681:China; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000175:diagnosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D014505:Urban Population