Metabolic Syndrome Is Associated with Greater Histologic Severity, Higher Carbohydrate, and Lower Fat Diet in Patients with NAFLD

Kang, Hellan; Greenson, Joel K.; Omo, Jason T; Chao, Cewin; Peterman, Debra; Anderson, Lilian; Foess-Wood, L.; Sherbondy, Mary Ann; Conjeevaram, Hari S.

doi:10.1111/j.1572-0241.2006.00719.x

Cited by 172 publications

(115 citation statements)

References 33 publications

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“…14 The presence and severity of the metabolic syndrome has been shown to be directly related to the severity of liver histology in subjects with NAFLD. [43][44][45] However, abdominal obesity had only a modest contribution to the severity of liver histology. It is likely that while the severity of the insulin-resistant state, which is related to abdominal obesity, drives the development of the features of the metabolic syndrome (for example, NAFLD), there are other factors (for example, genetics) that may determine the severity of the histological changes.…”

Section: Discussionmentioning

confidence: 99%

The impact of fat distribution on the severity of nonalcoholic fatty liver disease and metabolic syndrome

et al. 2007

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Section: Discussionmentioning

confidence: 99%

The impact of fat distribution on the severity of nonalcoholic fatty liver disease and metabolic syndrome

et al. 2007

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“…In both trials the patients receiving n-3 PUFA were found to be more likely to have complete fatty liver regression, suggesting a beneficial therapeutic effect for n-3 PUFA supplementation in NAFLD. Other studies have shown higher-carbohydrate and lower-fat diets to be associated with more progressive disease (84,85) . Conversely, very recent animal data have shown that in both mice (86) and non-human primates (87) exposure to a maternal high-fat diet leads to a disturbing development and progression of NAFLD in the offspring.…”

Section: Genetic and Environmental Factors Associated With Non-alcohomentioning

confidence: 98%

Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome

2010

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Non-alcoholic fatty liver disease (NAFLD) is now the most common liver disease in both adults and children worldwide. As a disease spectrum, NAFLD may progress from simple steatosis to steatohepatitis, advanced fibrosis and cirrhosis. An estimated 20-35% of the general population has steatosis, 10 % of whom will develop the more progressive non-alcoholic steatohepatitis associated with markedly increased risk of cardiovascular-and liver-related mortality. Development of NAFLD is strongly linked to components of the metabolic syndrome including obesity, insulin resistance, dyslipidaemia and type 2 diabetes. The recognition that NAFLD is an independent risk factor for CVD is a major public health concern. There is a great need for a sensitive non-invasive test for the early detection and assessment of the stage of NAFLD that could also be used to monitor response to treatment. The cellular and molecular aetiology of NAFLD is multi-factorial; genetic polymorphisms influencing NAFLD have been identified and nutrition is a modifiable environmental factor influencing NAFLD progression. Weight loss through diet and exercise is the primary recommendation in the clinical management of NAFLD. The application of systems biology to the identification of NAFLD biomarkers and factors involved in NAFLD progression is an area of promising research.

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“…However, definite diagnosis requires liver biopsy. 2 A number of studies have shown how components of MS may contribute to alanine aminotransferase (ALT) activity, [4][5][6] severe liver steatosis, 7,8 NASH activity, 8,9 fibrosis 8 or isolated portal fibrosis 10 in adults with NAFLD/NASH.…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome and liver histology in paediatric non-alcoholic steatohepatitis

et al. 2007

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Objective: Our aim was to estimate prevalence of metabolic syndrome (MS), obesity and comorbidities in a cohort of 120 children (3-18 years) with biopsy-proven non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) and to evaluate correlations between clinical or biochemical variables and liver histology. Research methods and procedures: MS was diagnosed according to the adapted National Cholesterol Education Program criteria. Homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI); and ISI composite, insulin secretion (insulin response at 30 min after a glucose load; HOMA-b cell; insulinogenic index) were all estimated. BMI z-score and total body fat (dual-energy X-ray absorptiometry) were evaluated as indexes of obesity. Results: MS was diagnosed in 66% of children. About 92% had weight above the 85th percentile, of which 42% were obese with weight above 97th percentile. Prevalence of hypertriglyceridaemia was 63%, low HDL cholesterol 45%, hypertension 40% and impaired glucose tolerance 10%. Levels of aminotransferases were higher as the number of comorbidities increased, the highest values being found in subjects with MS (Pp0.05). Prevalence of a grade of steatosis X2 (P ¼ 0.05) and fibrosis (Pp0.01) was higher in subjects with MS. Histology was associated significantly with higher values of a number of clinical and biochemical parameters (steatosis X2 with BMI z-score (P ¼ 0.04), fasting insulin (P ¼ 0.02), HOMA-IR (P ¼ 0.03), b-cell secretion (P ¼ 0.04); necroinflammation with BMI z-score (P ¼ 0.007), glucose (Pp0.0001), cholesterol (Pp0.04) and white blood cells (P ¼ 0.025); fibrosis with body weight (P ¼ 0.05), BMI z-score (P ¼ 0.03), cholesterol (P ¼ 0.05), triglycerides (P ¼ 0.05), fasting insulin (Pp0.0001) and mean values of the hormone at the OGTT (P ¼ 0.03), HOMA-IR (Pp0.0001)). Conclusion: Presence of MS or clinical and biochemical variables associated with the syndrome seems to be strictly related to histological features of NASH in paediatric fatty liver disease. Thus, routinely liver biopsy should be encouraged in these children.

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Metabolic Syndrome Is Associated with Greater Histologic Severity, Higher Carbohydrate, and Lower Fat Diet in Patients with NAFLD

Cited by 172 publications

References 33 publications

The impact of fat distribution on the severity of nonalcoholic fatty liver disease and metabolic syndrome

The impact of fat distribution on the severity of nonalcoholic fatty liver disease and metabolic syndrome

Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome

Metabolic syndrome and liver histology in paediatric non-alcoholic steatohepatitis

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