Abstract
IntroductionFatty liver is associated with metabolic syndrome (MetS) but it may also occur without MetS. Whether resolution of fatty liver in the general population affects risk of MetS is unknown. Our aim was to determine whether a change in fatty liver status (either the development of new fatty liver or the resolution of existing fatty liver) would modify the risk of de novo MetS.MethodsTwo thousand eighty-nine people without hypertension, diabetes, and MetS were examined at baseline and at 5-year follow-up using a retrospective cohort study design. Fatty liver status was assessed at baseline and at follow-up by ultrasonography. Adjusted hazard ratios (aHR) and 95 % confidence intervals (CIs) for de novo MetS at follow-up were calculated controlling for the potential confounders, compared to the reference group (people who never had fatty liver at baseline and follow-up).ResultsDuring follow-up, fatty liver developed in 251 people and fatty liver resolved in 112 people. After the adjustment for multiple confounders, persisting fatty liver and incident fatty liver development were associated with de novo MetS, with aHR of 2.60 (95 % CIs [1.61,4.20]) and 3.31 (95 % CIs [1.99,5.51]), respectively. Risk of new MetS in resolved fatty liver group was attenuated with insignificant aHR of 1.29 accompanying 95 % CIs of 0.60 and 2.80.DiscussionDevelopment or maintenance of fatty liver is positively associated with occurrence of new MetS. Resolution of fatty liver status has similar risk of de novo MetS with those who never had fatty liver. Therefore, cautious management is needed with those with fatty liver.
Highlights
Fatty liver is associated with metabolic syndrome (MetS) but it may occur without MetS
We have previously investigated relationships between change in fatty liver status and incident hypertension/diabetes [14, 15]
Triglyceride, high-density lipoprotein cholesterol (HDL-C), Body mass index (BMI), blood pressure, fasting insulin level, hepatic enzymes, and homeostatic model assessment-insulin resistance (HOMA-IR) were positively associated with the change of fatty liver status (p value
Summary
Fatty liver is associated with metabolic syndrome (MetS) but it may occur without MetS. NAFLD is recognized as the most common cause of liver disease worldwide, with a prevalence of 15–35.8 % in Western populations [2,3,4,5,6], 14–20 % in Japanese [7], and is more frequent in people with increased amounts of body fat, occurring in up to 85 % in overweight individuals and 98 % non-diabetic obese individuals [8]. The metabolic syndrome (MetS) is a cluster of cardiometabolic disorders which is known be a risk factor for development of atherosclerotic cardiovascular disease and stroke [9]. It occurs in association with central obesity and insulin resistance. It is reported that nearly 90 % of NAFLD patients have more than one component of metabolic syndrome [11], but it
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