건강검진에서 진단된 비알코올성 지방간의 대사적 특징 및 관련인자
Metabolic Characteristics and Associated Factors of Nonalcoholic Fatty Liver Disease Diagnosedat Medical Checkups
0
조회
0
다운로드
2
인용
0
참고문헌
초록
Abstract
Background : Nonalcoholic fatty liver disease (NAFLD) has been reported to be related with metabolic disorder and frequently accompanied by abnormal liver function. This study was performed to investigate the metabolic characteristics of NAFLD and its associated factors. Methods : We analysed 7,150 subjects diagnosed with NAFLD (n=2,381) or normal liver (n=4,769) and classified them into four groups based on ultrasonography and ALT levels as follows: 1) Control (normal liver and ALT), 2) increased ALT (normal liver with increased ALT), 3) NAFLD I (fatty liver with normal ALT), and 4) NAFLD II (fatty liver with increased ALT). Age, blood pressure, body mass index (BMI), fasting glucose, blood lipids, and high sensitivity C-reactive protein (hsCRP) were compared, and the incidence of metabolic syndrome was also determined in each group. Results : The diastolic blood pressure, BMI, fasting glucose, total cholesterol, triglyceride, hsCRP, and the incidence of metabolic syndrome, were the highest in the NAFLD II group, followed by the NAFLD I group, the increased ALT group, and the control group in descending order. Meanwhile, HDL cholesterol (HDL-C) was the lowest in the NAFLD II group. Male sex, age, systolic blood pressure, BMI, fasting glucose, triglyceride, LDL cholesterol (LDL-C), and hsCRP were associated with NAFLD (P<0.001). An increased level of ALT in NAFLD was significantly related with male sex, increased BMI, fasting glucose, triglyceride, and LDL-C, younger age and decreased HDL-C (P< 0.001). Conclusions : NAFLD was related with metabolic syndrome and the risk factors of cardiovascular disease in Koreans. The correlation was more prominent in NAFLD with increased ALT. Thus, a more intensive management is required for the individuals in the NAFLD with increased ALT. (Korean J Lab Med 2008;28:244-50)
참고문헌 (29)
- Hoang KC, "The metabolic syndrome in East Asians", J Cardiometab Syndr, 2, pp.276~282 (2007)
- Angelico F, "Non-alcoholic fatty liver syndrome: a hepatic consequence of common metabolic diseases", J Gastroenterol Hepatol, 18, pp.588~594 (2003)
- Falck-Ytter Y, "Clinical features and natural history of nonalcoholic steatosis syndromes", Semin Liver Dis, 21, pp.17~26 (2001)
- Choudhury J, "Clinical aspects of fatty liver disease", Semin Liver Dis, 24, pp.349~362 (2004)
- Neuschwander-Tetri BA, "Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference", Hepatology 2003, 통권 : 37, pp.1202~1219 (2003)
- Villanova N, "Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease", Hepatology, 42, pp.473~480 (2005)
- Shen YH, "Bright liver and alanine aminotransferase are associated with metabolic syndrome in adults", Obes Res, 13, pp.1238~1245 (2005)
- Daniel S, "Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptomatic and symptomatic patients", Am J Gastroenterol, 94, pp.3010~3014 (1999)
- Saadeh S, "The utility of radiological imaging in nonalcoholic fatty liver disease", Gastroenterology, 123, pp.745~750 (2002)
- Osawa H, "Sonographic diagnosis of fatty liver using a histogram technique that compares liver and renal cortical echo amplitudes", J Clin Ultrasound, 24, pp.25~29 (1996)
- Saverymuttu SH, "Ultasound scanning in the detection of hepatic fibrosis and steatosis", Br Med J, 292, pp.13~15 (1986)
- Stone NJ, "Recent national cholesterol education program adult treatment panel III update: adjustments and options", Am J Cardiol, 96, pp.53E~59E (2005)
- Joseph AE, "Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease", Clin Radiol, 43, pp.26~31 (1991)
- Mendler MH, "Dual-energy CT in the diagnosis and quantification of fatty liver: limited clinical value in comparison to ultrasound scan and single-energy CT, with special reference to iron overload", J Hepatol, 28, pp.785~794 (1998)
- Layer G, "Computerized ultrasound B-scan texture analysis of experimental diffuse parenchymal liver disease: correlation with histopathology and tissue composition", J Clin Ultrasound, 19, pp.193~201 (1991)
- Fan JG, "Prevalence of and risk factors for fatty liver in a general population of Shanghai", China. J Hepatol, 43, pp.508~514 (2005)
- Browning JD, "Prevalence of hepatic steatosis in an urban population in the United States: impact of ethinicity", Hepatology, 40, pp.1387~1395 (2004)
- Marchesini G, "Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome", Hepatology, 37, pp.917~923 (2003)
- Chen CH, "Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults", J Clin Gastroenterol, 40, pp.745~752 (2006)
- Omagari K, "Fatty liver in non-alcoholic non-overweight Japanese adults:incidence and clinical characteristics", J Gastroenterol Hepatol, 17, pp.1098~1105 (2002)
- Adams LA, "Nonalcoholic fatty liver disease", CMAJ, 172, pp.899~905 (2005)
- Bugianesi E, "Insulin resistance: a metabolic pathway to chronic liver disease", Hepatology, 42, pp.987~1000 (2005)
- Bedogni G, "Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study", Hepatology, 42, pp.44~52 (2005)
- Zelber-Sagi S, "Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures", Liver Int, 26, pp.856~863 (2006)
- Oh SY, "The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease", Metabolism, 55, pp.1604~1609 (2006)
- 김현창, "Normal Serum Aminotransferase Levels and the Metabolic Syndrome: Korean National Health and Nutrition Examination Surveys", Yonsei Medical Journal, 47(4), pp.542~550 (2006), 연세대학교의과대학
- Mofrad P, "Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values", Hepatology, 37, pp.1286~1292 (2003)
- Powell EE, "The natural history of nonalcoholic steatohepatitis: a followup study of forty-two patients for up to 21 years", Hepatology, 11, pp.74~80 (1990)
- Ratziu V, "Liver fibrosis in overweight patients", Gastroenterology, 118, pp.1117~1123 (2000)
