Evaluation of clinical and inflammatory markers of nonalcoholic fatty liver disease in postmenopausal women with metabolic syndrome.

Abstract

The aim of this study was to assess clinical and inflammatory markers in nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with metabolic syndrome. This cross-sectional study included 180 Brazilian women (age ≥45 years and amenorrhea ≥12 months). Metabolic syndrome was diagnosed by the presence of at least three of the following indicators: Waist circumference (WC) >88 cm, triglycerides (TGs) ≥150 mg/dL, high-density lipoprotein (HDL) <50 mg/dL; blood pressure ≥130/85 mmHg; and glucose ≥100 mg/dL. NAFLD was diagnosed by abdominal ultrasound. Participants were divided into three groups: Metabolic syndrome alone (n=53); metabolic syndrome+NAFLD (n=67); or absence of metabolic syndrome or NAFLD (control, n=60). Clinical, anthropometric, and biochemical variables were quantified. The inflammatory profile included adiponectin, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Data were submitted to statistical analysis using a Tukey test, analysis of variance (ANOVA), chi-squared, Pearson correlation, and logistic regression (odds ratio, OR). Women with metabolic syndrome+NAFLD, abdominal obesity, high glucose, and insulin resistance by HOMA-IR were compared to women with metabolic syndrome alone and controls (P<0.05). High values of IL-6 and TNF-α and low values of adiponectin were observed among women with metabolic syndrome alone or metabolic syndrome+NAFLD when compared to controls (P<0.05). In multivariate analysis, the variables considered as risk of NAFLD development were: High systolic blood pressure (SBP) [(OR 1.02, 95% confidence interval (CI) 1.0-1.04]; large WC (OR 1.07, 95% CI 1.01-1.13); insulin resistance (OR 3.81, 95% CI 2.01-7.13); and metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). Adiponectin levels reduced NAFLD risk (OR 0.88, 95% CI 0.80-0.96). In postmenopausal women, metabolic syndrome, abdominal obesity, and insulin resistance were risk markers for the development of NAFLD, whereas higher adiponectin values indicated a protection marker.