title: Association between serum calcium and phosphorus concentrations with non-alcoholic fatty liver disease in Korean population.
abstract: OBJECTIVE
  Growing evidence suggests that non-alcoholic fatty liver disease (NAFLD) is interrelated with renal dysfunction and disturbed bone metabolism, both of which play a key role in calcium and phosphorus homeostasis. We investigated the association between NAFLD and serum calcium and phosphorus levels in Korean subjects.
  
  
  METHODS
  We performed a cross-sectional analysis of 16,592 subjects undergoing a general health checkup. NAFLD was assessed based on ultrasonographically detected fatty liver in the absence of excessive alcohol consumption and other causes of liver disease.
  
  
  RESULTS
  The proportion of the population with fatty liver detected by ultrasonography was 43.2% for males and 17.6% for females. We observed that a higher serum albumin-corrected calcium (Ca(c)) level was associated with smoking, hypertension, and unfavorable metabolic parameters in both genders, but the serum phosphorus levels showed an inconsistent correlation with metabolic abnormalities. After adjusting for age, gender, waist circumference, body mass index, smoking status, exercise, diabetes, hypertension, lipid profiles, and renal function, serum Cac , phosphorus, and Cac -phosphorus products were independent risk factors for fatty liver (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.49-1.95, P < 0.001; OR: 1.34, 95% CI: 1.22-1.48, P < 0.001; and OR: 1.20, 95% CI: 1.14-1.26, P < 0.001, respectively), and the risk of fatty liver increased in a graded manner over the quartiles.
  
  
  CONCLUSIONS
  Serum calcium and phosphorus levels are significantly associated with NAFLD. Further investigation is needed to verify whether calcium and phosphorus levels indicate a higher risk of NAFLD.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Korea College of Medicine, Incheon St. Mary's Hospital, Incheon, Korea.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Shin
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Kim
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Kim
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Mo
authors.forename: Sung Dae
authors.initials: SD
authors.lastname: Moon
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Bong Yeon
authors.initials: BY
authors.lastname: Cha
mesh_terms: D000328:Adult; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D010758:Phosphorus / Q000097:blood*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010758:Phosphorus; D002118:Calcium
keywords: non-alcoholic fatty liver disease; serum calcium; serum phosphorus