Department of Gastroenterology, Kagawa Prefectural Cancer Detection Center, 587-1 Goto-cho, Takamatsu, Kagawa 761-8031, Japan.
J Gastroenterol. 2012 Mar;47(3):293-9. doi: 10.1007/s00535-011-0489-4. Epub 2011 Nov 9.
Although metabolic syndrome (MS) is likely to be associated with nonalcoholic fatty liver disease (NAFLD), visceral fat type MS and subcutaneous fat type MS have not been distinguished. In this study, we divided persons with MS into those with visceral and subcutaneous fat types by ultrasonography (US), and elucidated differences between these types of MS in Japanese males.
The subjects were 628 males with MS who underwent a medical checkup including abdominal US. We examined for the presence of fatty liver and investigated biochemical parameters, and we also made a distinction between visceral and subcutaneous fat types of MS by US.
Total cholesterol (T-CHO), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the frequency of fatty liver were significantly higher in visceral fat type MS than in subcutaneous fat type MS. On logistic regression analysis with NAFLD (in our study, fatty liver with ALT ≥31 IU/l was defined as NAFLD) as a dependent variable, the age, body mass index (BMI), AST, and visceral fat type MS were significant risk factors for NAFLD. BMI, AST, and visceral fat type MS were predictors of an increased prevalence of NAFLD [odds ratios (ORs) = 1.903, 12.06, and 2.617; 95% confidence intervals (CIs) = 1.122-3.228, 7.053-20.61, and 1.741-3.935; p = 0.017, <0.001, and <0.001, respectively).
Japanese males with visceral fat type MS are more likely to have dyslipidemia, fatty liver, and liver dysfunction than those with subcutaneous fat type MS. Visceral fat type MS is one of the most significant risk factors for NAFLD in Japanese males with MS.
尽管代谢综合征(MS)可能与非酒精性脂肪肝(NAFLD)有关,但尚未区分内脏脂肪型 MS 和皮下脂肪型 MS。在这项研究中,我们通过超声(US)将 MS 患者分为内脏脂肪型和皮下脂肪型,并阐明了这两种 MS 类型在日本男性中的差异。
本研究的对象是 628 名接受包括腹部 US 在内的体检的 MS 男性患者。我们检查了脂肪肝的存在情况,并调查了生化参数,还通过 US 区分了 MS 的内脏脂肪型和皮下脂肪型。
与皮下脂肪型 MS 相比,内脏脂肪型 MS 的总胆固醇(T-CHO)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和脂肪肝的发生率明显更高。以 NAFLD(在我们的研究中,ALT≥31IU/l 的脂肪肝定义为 NAFLD)为因变量的 logistic 回归分析显示,年龄、体重指数(BMI)、AST 和内脏脂肪型 MS 是 NAFLD 的显著危险因素。BMI、AST 和内脏脂肪型 MS 是 NAFLD 患病率增加的预测因素[比值比(ORs)=1.903、12.06 和 2.617;95%置信区间(CI)=1.122-3.228、7.053-20.61 和 1.741-3.935;p=0.017、<0.001 和<0.001]。
与皮下脂肪型 MS 相比,日本男性内脏脂肪型 MS 更易发生血脂异常、脂肪肝和肝功能障碍。内脏脂肪型 MS 是日本男性 MS 患者中 NAFLD 的最重要危险因素之一。