title: Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age-dependent risk profiling study.
abstract: Metabolic syndrome (MS) and its individual components are associated with the severity and progression of nonalcoholic fatty liver disease (NAFLD). We sought to evaluate the relationship between MS components and the risk of severe hepatic fibrosis in NAFLD patients discriminated by age.
  
  
  
  We considered 863 consecutive patients with biopsy-proven NAFLD, who had been fully evaluated for components of MS.
  
  
  
  Multivariate logistic regression analysis showed that F3-F4 was associated with visceral obesity, IFG/diabetes, and low high-density lipoprotein (HDL) cholesterol, but not triglycerides >150 or arterial hypertension. A significant interaction was found between age and visceral obesity (P=.04). By stratifying patients for age, we confirmed the interaction between inclusion in the third age tertile (>54 years) and visceral obesity (P=.04). In the lower (<41 years) and middle (41-54 years) age tertiles, the risk for F3-F4 fibrosis was mostly driven by visceral obesity and IFG/diabetes. This risk was higher in those with all three metabolic risk factors. Finally, among patients in the higher age tertile (>54 years), obesity did not affect the severity of fibrosis, and the risk of severe fibrosis was higher in those with low HDL and IFG/diabetes with/without visceral obesity (52%-54%).
  
  
  
  Among patients with NAFLD, the metabolic profiles associated with risk for severe fibrosis varied among age groups. Low HDL, obesity and IFG/diabetes were prevalent among patients in the lower and middle age tertiles. HDL and IFG/diabetes but not visceral obesity were prevalent among those in the highest age tertile.
authors.affiliation: Section of Gastroenterology, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.identifier: 0000-0002-0822-9673
authors.initials: S
authors.lastname: Petta
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Eslam
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi, Internal Medicine, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Luca
authors.identifier: 0000-0001-8909-0345
authors.initials: L
authors.lastname: Valenti
authors.affiliation: Division of Gastro-Hepatology, Department of Medical Sciences, San Giovanni Battista Hospital, University of Torino, Torino, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bugianesi
authors.affiliation: Section of Gastroenterology, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Barbara
authors.affiliation: Section of Gastroenterology, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
authors.forename: Calogero
authors.identifier: 0000-0002-9224-1914
authors.initials: C
authors.lastname: Cammà
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi, Internal Medicine, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Porzio
authors.affiliation: Division of Gastro-Hepatology, Department of Medical Sciences, San Giovanni Battista Hospital, University of Torino, Torino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosso
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi, Internal Medicine, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fargion
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.affiliation: Section of Gastroenterology, Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007558:Italy; D008075:Lipoproteins, HDL / Q000097:blood; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000473:pathology; D056128:Obesity, Abdominal / Q000150:complications*; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D008075:Lipoproteins, HDL
keywords: diabetes; metabolic syndrome; nonalcoholic fatty liver disease; obesity