title: Sex Difference in the Association between Serum Homocysteine Level and Non-Alcoholic Fatty Liver Disease.
abstract: BACKGROUND
  The relationship between serum homocysteine levels and non-alcoholic fatty liver disease is poorly understood. This study aims to investigate the sex-specific relationship between serum homocysteine level and non-alcoholic fatty liver disease in the Korean population.
  
  
  METHODS
  This cross-sectional study included 150 men and 132 women who participated in medical examination programs in Korea from January 2014 to December 2014. Patients were screened for fatty liver by abdominal ultrasound and patient blood samples were collected to measure homocysteine levels. Patients that consumed more than 20 grams of alcohol per day were excluded from this study.
  
  
  RESULTS
  The homocysteine level (11.56 vs. 8.05 nmol/L) and the proportion of non-alcoholic fatty liver disease (60.7% vs. 19.7%) were significantly higher in men than in women. In men, elevated serum homocysteine levels were associated with a greater prevalence of non-alcoholic fatty liver disease (quartile 1, 43.6%; quartile 4, 80.6%; P=0.01); however, in females, there was no significant association between serum homocysteine levels and the prevalence of non-alcoholic fatty liver disease. In the logistic regression model adjusted for age and potential confounding parameters, the odds ratio for men was significantly higher in the uppermost quartile (model 3, quartile 4: odds ratio, 6.78; 95% confidential interval, 1.67 to 27.56); however, serum homocysteine levels in women were not associated with non-alcoholic fatty liver disease in the crude model or in models adjusted for confounders.
  
  
  CONCLUSIONS
  Serum homocysteine levels were associated with the prevalence of non-alcoholic fatty liver disease in men.
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Bo-Youn
authors.initials: BY
authors.lastname: Won
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Kyung-Chae
authors.initials: KC
authors.lastname: Park
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Soo-Hyun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Yun
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Moon-Jong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Kye-Seon
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Young-Sang
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Ji-Hee
authors.initials: JH
authors.lastname: Haam
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Hyung-Yuk
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Hye-Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Park
keywords: Fatty Liver; Homocysteine; Men; Non-Alcoholic Fatty Liver Disease; Sex Characteristics