Abstract
Nonalcoholic fatty liver disease (NAFLD) is associated with all the components of metabolic syndrome (MS) and might to be considered an additional component of MS itself. The Italian Society for the Study of Atherosclerosis (SISA) in 2005 started a research project aimed to study the NAFLD, using ultrasound (US), in nondiabetic MS subjects matching at least one of the ATP III criteria for HDL-C or triglycerides [TG]. Prevalence of US-NAFLD and its associated risk factors and prevalence of hypertransaminasemia and its possible determinants were evaluated. NAFLD prevalence was 0.78. Men with steatosis compared to men without steatosis were younger (P < 0.05) with higher TG (P < 0.03), homeostasis model assessment insulin resistance (HOMA-R) (P < 0.003), and visceral fat thickness (VFT) (P < 0.0001). Women with steatosis showed higher TG (P < 0.05), HOMA-R (P < 0.04), VFT (P < 0.0001), and lower age (P < 0.05). At multivariate analyses, VFT (P < 0.0001), HOMA-R (P < 0.02), and TG/HDL (P < 0.05) were associated with severity of NAFLD. Age (P < 0.05), LogTG (P < 0.005), and VFT (P < 0.01) were associated with higher ALT. The US prevalence of steatosis in this study (0.78) is the highest reported in patients with MS. Considering the exclusion of severe obese and diabetic patients and the recruitment criteria, this finding highlights the prominent role played by the alterations of lipid metabolism in the pathogenesis of NAFLD.
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Acknowledgments
This project has received the support of grant “Programma per la Ricerca Sanitaria 2003: attività di ricerca finalizzata” from the Italian Ministry of Health. MRA, MS, and ABC are recipients of grant “Ex 60 %” from the University of Palermo.
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Communicated by Massimo Federici.
This study is conducted on behalf of the Metabolic Syndrome Study Group. A complete list of the members of the Metabolic Syndrome Study Group and their affiliations can be found in Appendix.
Maurizio Soresi and Davide Noto equally contributed to this work.
Appendix
Appendix
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Azienda Ospedaliera Policlinico Mater Domini, University of Catanzaro—Arturo Pujia, Tiziana Montalcini
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Dipartimento Medicina e Scienze dell’Invecchiamento—University of Chieti—Andrea Mezzetti, Marco Bucci
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Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia—Elmo Mannarino, Matteo Pirro
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Department of Pharmacological Sciences, University of Milan—Alberico Catapano, Danilo Norata
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Department of Clinical and Experimental Medicine, University ‘Federico II’ Medical School, Naples—Paolo Rubba, Marco Gentile
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Department of Internal Medicine and Medical Specialties (DIMIS), University of Palermo—Gianfranco Cocorullo, Giuseppe Montalto
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Department of Medical and Surgical Sciences, University of Padova—Enzo Manzato, Scipione Martini
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Department of Internal Medicine, Gerontology and Clinical Nutrition, University of Ferrara—Renato Fellin, Giovanni Battista Vigna
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Department of Medical Technological and Translational Sciences—DMTTS, University of Trieste—Luigi Cattin, Maurizio Fonda
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Dipartimento di Medicina Interna University of Rome “Tor Vergata”—Massimo Federici, Davide Lauro.
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Soresi, M., Noto, D., Cefalù, A.B. et al. Nonalcoholic fatty liver and metabolic syndrome in Italy: results from a multicentric study of the Italian Arteriosclerosis society. Acta Diabetol 50, 241–249 (2013). https://doi.org/10.1007/s00592-012-0406-1
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DOI: https://doi.org/10.1007/s00592-012-0406-1