Journal of Obesity & Metabolic Syndrome



Korean J Obes 2008; 17(3): 124-131

Published online September 1, 2008

Copyright © Korean Society for the Study of Obesity.

Risk Factors associated with Metabolic Syndrome in Ultrasonographic Fatty Liver

Cheol Soon Im, Sung Soo Kim*†

Department of Family Medicine, Okcheon Sungmo Hospital; and
Department of Family Medicine, Chungnam National University Hospital(1)


Background: The aim of this study was to determine how much impact the risk factors of metabolic syndrome has on ultrasonographic fatty liver(USFL).
Methods: A total of 462 adult patients participated in this study. Fatty liver was diagnosed by ultrasonography. There were 189 cases of control (without fatty liver) and 273 cases of USFL. USFL consisted of NAFLD (n=191) and AFLD (n=75). The criteria of Metabolic syndrome were defined according to NCEP-ATP III criteria with a modified waist circumference cutoff value (men > 90 cm; women > 85 cm). Factors related to metabolic syndrome were assessed by Chi square test and logistic regression analysis.
Results: Factors such as heavy drinking, smoking, inactivity, obesity, and central obesity were more prominent among patients of USFL, in addition blood pressure, triglyceride, high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transpeptidase (GGT) levels were significantly higher among patients of USFL compared to those of control (P<0.05). Obesity, central obesity, heavy drinking, smoking, and inactivity were significantly associated with fatty liver. Obesity (BMI ≥25) and ALT >35 (upper normal limit) were associated with metabolic syndrome in USFL patients after adjustment of various variables such as above. Odds ratios of obesity and ALT were 3.76 (95% CI 1.10-12.82) and 6.56 (95% CI 1.71-25.06), respectively. Predictive value positive (PVP) of 'USFL', 'USFL+obesity', and 'USFL+obesity+ALT' for metabolic syndrome were 16.1%, 27.2% and 35.0%, respectively in NAFLD. PVP of 'USFL', 'USFL+obesity', and 'USFL+obesity+ALT' for metabolic syndrome were 24.3%, 35.7%, and 52.9%, respectively in AFLD.
Conclusions: Obesity and increased ALT are associated with metabolic syndrome in patients with ultrasonographic fatty liver.

Keywords: fatty liver, metabolic syndrome, alanine aminotransferase, ultrasonography