Hepatic Fibrosis and Steatosis in Metabolic Syndrome

Abstract

Journal of Obesity & Metabolic SyndromeThis is a PDF file of an article accepted, but it is not yet the definitive version of record. Background: Metabolic syndrome (MetS) is a group of factors associated with increased risks of cardiovascular disease and overall mortality. Nonalcoholic fatty liver disease (NAFLD) is a common disorder that has been shown to cause hepatic steatosis and fibrosis. The relationship between NAFLD and MetS appears to be bidirectional, but very few studies have examined the role of MetS in hepatic steatosis and fibrosis. The present study investigated the relationships between MetS and its components and the severity of hepatic fibrosis and steatosis, and fibrosis independent of steatosis. Methods: The study was a cross-sectional population-based survey of 4,678 National Health and Nutrition Examination Survey participants from 2017 to 2018 in the United States. Hepatic fibrosis and steatosis were measured using liver elastography. The MetS components were assessed using demographic, examination, laboratory, and self-reported data.Results: Using survey-weighted population estimates, 26% of the population had steatosis, 7.5% had fibrosis, and 3.3% had fibrosis without steatosis. The adjusted odds ratio for any level of steatosis was 4.12 times higher (95% confidence interval [CI], 3.16-5.37) and any level of fibrosis was 3.34 times higher (95% CI, 2.26-4.94) among participants with MetS than those without. The adjusted odds ratio for fibrosis without steatosis is 2.67 times higher (95% CI, 1.47-4.87) among participants with MetS than those without. Conclusion:The presence of MetS significantly increases the risk of hepatic fibrosis and steatosis, providing evidence for MetS to be considered an additional independent risk factor for hepatic fibrosis together with other known etiologies.

Association between type 2 diabetes status and prevalence of liver steatosis and fibrosis among adults aged ≥ 40 years

“…Second, we excluded participants with age of DM onset of < 30 years of age to minimize the number of participants with T1DM, as previously described [ 26 , 27 ], as the NHANES database does not differentiate diabetes by type. Third, the values of CAP defining hepatic steatosis and LSM defining significant fibrosis are both inconsistent among different studies using NAHENS 2017–2018 database [ 13 , 28 , 29 ]. Thus, the sensitivity and specificity of TE test may vary depending on the cut-off values.…”

Metabolic Syndrome: A Warning Sign of Liver Fibrosis

“…In this issue of Journal of Obesity & Metabolic Syndrome , Gangireddy et al 9 investigated the relationships between MetS and its components with hepatic fibrosis and steatosis in a cross-sectional study using National Health and Nutrition Examination Survey data. As expected, they showed that subjects with MetS had a greater than three-fold increased risk of hepatic steatosis and fibrosis than subjects without MetS.…”

“…Gangireddy et al 9 have contributed to awareness of the increased risk of liver fibrosis in MetS regardless of the presence or absence of steatosis. Larger, prospective studies are needed to confirm any independent contribution of MetS itself to the risk of hepatic fibrosis without steatosis.…”

Letter: Hepatic Fibrosis and Steatosis in Metabolic Syndrome (J Obes Metab Syndr 2022;31:61-9)

“…Nevertheless, as a study targeting the general population in the United States, Gangireddy et al's study 5 is meaningful and proves a relationship between hepatic fibrosis and steatosis and…”

“…MetS was not significantly related to advanced liver fibrosis in biopsy-proven metabolic dysfunctionassociated fatty liver disease patients 3 and MetS was not associated with hepatic fibrosis among individuals with hereditary hemochromatosis. 4 Gangireddy et al 5 also has some strengths in that hepatic fibrosis and steatosis were evaluated through liver ultrasound. However, as mentioned in the paper, the fact that hepatic fibrosis and steatosis were not evaluated by liver biopsy is one limitation, and it is necessary to consider a method to address this weakness.…”