Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome
Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome
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DOI：
10.3748/wjg.v18.i13.1508
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发表时间：
2012-04-07
影响因子：
4.3
通讯作者：
Takeda, Jun
中科院分区：
文献类型：
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作者：
Hamaguchi, Masahide;Takeda, Noriyuki;Takeda, Jun
目的：为了阐明代谢综合征标准检测非酒精性脂肪性肝病（NAFLD）的有效性，方法：作者进行了一项横断面研究，包括腹部超声检查的医疗健康检查计划的参与者。这项研究涉及11714名年龄在18至83岁之间的健康日本男性和女性。NAFLD是通过腹部超声检查定义的，没有超过20 g/d的酒精摄入量，已知的肝脏疾病，或目前使用的药物。修订后的标准的国家胆固醇教育计划成人治疗小组III被用来表征metabolic syndrome.RESULTS：NAFLD被检测到32.2%（95%CI：31.0%-33.5%）的男性（n = 1874 5811）和8.7%（95%CI：8.0%-9.5%）的女性（n = 514 5903）。在肥胖人群中，NAFLD的患病率男性高达67.3%（95%CI：64.8%-69.7%），女性高达45.8%（95%CI：41.7%-50.0%）。虽然NAFLD被认为是代谢综合征的肝脏表型，但NAFLD受试者中代谢综合征的患病率在男性和女性中均较低。66.8%的男性和70.4%的女性NAFLD患者未被诊断为代谢综合征。48.2%的NAFLD男性和49.8%的NAFLD女性没有超重[体重指数（BMI）>= 25 kg/m2]。同样，68.6%的NAFLD男性和37.9%的NAFLD女性对腹部分级不满意（男性>= 90 cm，女性>= 80 cm）。接下来，作者将其定义为当参与者满足至少一项代谢综合征标准时NAFLD筛查阳性。“至少有一项标准”定义的敏感性在男性中为84.8%，在女性中为86.6%。按BMI分组，肥胖男性和女性的敏感性均高于非肥胖男性和女性（男性92.3%vs76.8%，女性96.1%vs77.0%）。结论：通过修改代谢综合征诊断标准，可在流行病学研究中有效地诊断NAFLD。(C)2012年百世登。All rights reserved.
AIM: To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD).METHODS: Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography. This study involved 11 714 apparently healthy Japanese men and women, 18 to 83 years of age. NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d, known liver disease, or current use of medication. The revised criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.RESULTS: NAFLD was detected in 32.2% (95% CI: 31.0%-33.5%) of men (n = 1874 of 5811) and in 8.7% (95% CI: 8.0%-9.5%) of women (n = 514 of 5903). Among obese people, the prevalence of NAFLD was as high as 67.3% (95% CI: 64.8%-69.7%) in men and 45.8% (95% CI: 41.7%-50.0%) in women. Although NAFLD was thought of as being the liver phenotype of metabolic syndrome, the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women. 66.8% of men and 70.4% of women with NAFLD were not diagnosed with the metabolic syndrome. 48.2% of men with NAFLD and 49.8% of women with NAFLD weren't overweight [body mass index (BMI) >= 25 kg/m(2)]. In the same way, 68.6% of men with NAFLD and 37.9% of women with NAFLD weren't satisfied with abdominal classification (>= 90 cm for men and >= 80 cm for women). Next, authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome. The sensitivity of the definition "at least 1 criterion" was as good as 84.8% in men and 86.6% in women. Separating subjects by BMI, the sensitivity was higher in obese men and women than in non-obese men and women (92.3% vs 76.8% in men, 96.1% vs 77.0% in women, respectively).CONCLUSION: Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome. (C) 2012 Baishideng. All rights reserved.