title: Nonalcoholic Fatty Liver: The Association with Metabolic Abnormalities, Body Mass Index and Central Obesity--A Population-Based Study.
abstract: BACKGROUND
  To assess the prevalence of nonalcoholic fatty liver (NAFL) in Iran and to evaluate correlates of NAFL in categories of body mass index (BMI).
  
  
  METHODS
  Using a cluster random sampling approach, 7723 subjects over 18 years of age underwent abdominal ultrasonography, laboratory evaluations, blood pressure, and anthropometric measurements and were interviewed to obtain baseline characteristics. Prevalence of NAFL according to BMI and waist to hip ratio and its association with metabolic abnormalities in categories of BMI were assessed in multivariate analysis.
  
  
  RESULTS
  The overall prevalence of NAFL was 35.2% [95% confidence interval (CI) 34.1-36.3]. A significant number of subjects with BMI < 30 had NAFL [22.1% (CI 21.0-23.2)]. Waist to hip ratio for 38.2% (CI 35.6-40.8) of the subjects with NAFL, and BMI < 30 was higher than normal values. The odds ratio for association of NAFL and dyslipidemias were higher in subjects with BMI < 30 versus those with BMI ≥ 30: (1) hypertriglyceridemia: 2.21 vs. 1.57, P = 0.006; (2) lower high-density lipoprotein: 1.29 versus 0.98, P = 0.046. Higher low-density lipoprotein also revealed greater association with NAFL in subjects with BMI < 25 than those with BMI ≥ 25 (odds ratio 1.84 vs. 1.1, P = 0.015).
  
  
  CONCLUSIONS
  NAFL shows stronger association with central obesity compared to high BMI. NAFL has stronger association with dyslipidemias in subjects with low compared with high BMI.
authors.affiliation: 1 Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions , Baltimore, Maryland.|2 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ostovaneh
authors.affiliation: 3 Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Farhad
authors.initials: F
authors.lastname: Zamani
authors.affiliation: 4 Health Promotion Research Center, Zahedan University of Medical Sciences , Zahedan, Iran .
authors.forename: Alireza
authors.initials: A
authors.lastname: Ansari-Moghaddam
authors.affiliation: 2 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharafkhah
authors.affiliation: 3 Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Fatemeh Sima
authors.initials: FS
authors.lastname: Saeedian
authors.affiliation: 4 Health Promotion Research Center, Zahedan University of Medical Sciences , Zahedan, Iran .
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Rohani
authors.affiliation: 4 Health Promotion Research Center, Zahedan University of Medical Sciences , Zahedan, Iran .
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Khoonsari
authors.affiliation: 2 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Gilda
authors.initials: G
authors.lastname: Barzin
authors.affiliation: 3 Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Hemmasi
authors.affiliation: 3 Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Hossein
authors.initials: H
authors.lastname: Ajdarkosh
authors.affiliation: 2 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Aezam
authors.initials: A
authors.lastname: Katoonizadeh
authors.affiliation: 3 Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Mansoureh
authors.initials: M
authors.lastname: Maadi
authors.affiliation: 5 Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: 2 Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran .
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers; D008055:Lipids