Severity of metabolic syndrome is greater among nonalcoholic adults with elevated ALT and advanced fibrosis.
Fibrosis
Metabolic syndrome
Nonalcoholic fatty liver disease
Nonalcoholic steatohepatitis
Risk
Journal
Nutrition research (New York, N.Y.)
ISSN: 1879-0739
Titre abrégé: Nutr Res
Pays: United States
ID NLM: 8303331
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
04
05
2020
revised:
11
09
2020
accepted:
22
12
2020
pubmed:
21
3
2021
medline:
9
10
2021
entrez:
20
3
2021
Statut:
ppublish
Résumé
The obesity epidemic has increased risk for nonalcoholic fatty-liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), advanced fibrosis and cirrhosis. We hypothesized that metabolic syndrome (MetS) severity would correlate with markers of NAFLD and NASH fibrosis. We evaluated cross-sectional data from 5463 participants of the National Health and Nutrition Examination Survey 1999-2012, age 20 to 64 years with and without diabetes, excluding those with heavy drinking and infectious liver serologies. We used linear and logistic regression to evaluate links between MetS-severity (using a race/ethnicity-specific MetS-severity-Z-score, MetS-Z) and apparent NALFD sequelae, using elevated alanine aminotransferase (ALT) to determine presence of NAFLD and elevated NAFLD Fibrosis Score to identify advanced fibrosis (NASH Clinical Research Network scoring stage 3-4). The prevalence of unexplained ALT elevations and advanced fibrosis were 11.4% and 1.37%, respectively. MetS-Z-scores were higher among those with elevated ALT (0.7, 95% confidence interval [CI]: 0.6, 0.8) and advanced fibrosis (1.7, CI: 1.5,1.9), compared to those without liver abnormalities (0.2, CI:0.2, 0.3). For every 1-standard-deviation unit increase in MetS-Z, there were higher odds of elevated ALT (OR = 1.58, CI: 1.44, 1.72) and advanced fibrosis (OR = 1.96, CI: 1.77, 2.18), with some attenuation after adjustment for age, sex, race/ethnicity, and diabetes status. Significant differences were noted by race/ethnicity, with stronger links among whites versus blacks. The degree of MetS-severity was associated with progressive increase in apparent NAFLD and advanced fibrosis; as MetS-severity has also been linked to future cardiovascular disease, diabetes, and chronic kidney disease, this provides support for use of a MetS-severity score to screen for general health, with high levels triggering further assessment for liver abnormalities.
Identifiants
pubmed: 33743323
pii: S0271-5317(20)30607-2
doi: 10.1016/j.nutres.2020.12.023
pmc: PMC8048170
mid: NIHMS1684853
pii:
doi:
Substances chimiques
Alanine Transaminase
EC 2.6.1.2
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
34-43Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL120960
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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