Department of Internal Medicine, Regional Hospital 1, Mexico DF, Mexico.
Eur J Gastroenterol Hepatol. 2012 Jul;24(7):805-10. doi: 10.1097/MEG.0b013e328354044a.
The incidence of metabolic syndrome has increased in Mexico and nonalcoholic fatty liver disease (NAFLD) is a common complication. The authors aimed to evaluate the role of hepatic enzymes as biomarkers for NAFLD in patients presenting metabolic syndrome.
We studied 193 nondiabetic individuals with metabolic syndrome identified from a population-based cross-sectional survey. To identify NAFLD, real-time gray-scale abdominal ultrasound was performed, and the right, left, and caudate hepatic lobules were observed to assess the size, echogenicity, and borders of the liver. All individuals answered a questionnaire for risk factors, and anthropometric measures and blood pressure were obtained. The concentration of hepatic enzymes and insulin in blood was measured and the Homeostatic Model Assessment index was calculated.
A total of 160 individuals were identified as presenting NAFLD (82.9%). Body weight, BMI, and the waist-hip ratio increased as a direct result of the presence and severity of fatty liver. A similar situation was observed in the levels of triglyceride and hepatic enzymes aspartate aminotransferase and γ-glutamyltransferase (GGT), basal insulin level, and the Homeostatic Model Assessment index. In a multivariate model, the variables associated with the occurrence of NAFLD were sex, triglyceride and GGT levels, and obesity.
The main factors that predict the occurrence of NAFLD are levels of triglyceride and GGT in the blood, as well as obesity. The accumulation of fat in the liver, in addition to increased oxidation and oxidative stress at the hepatic level, may be the mechanisms through which these factors increase the risk of NAFLD.
代谢综合征在墨西哥的发病率有所增加，非酒精性脂肪性肝病（NAFLD）是一种常见的并发症。作者旨在评估肝酶作为代谢综合征患者 NAFLD 生物标志物的作用。
我们研究了来自基于人群的横断面调查中确定的 193 名非糖尿病代谢综合征患者。为了确定 NAFLD，进行了实时灰阶腹部超声检查，并观察了右、左和尾状叶肝段以评估肝脏的大小、回声和边界。所有个体均回答了危险因素问卷，并进行了人体测量和血压测量。测量了血液中肝酶和胰岛素的浓度，并计算了稳态模型评估指数。
共有 160 名患者被确定为患有 NAFLD（82.9%）。体重、BMI 和腰臀比随着脂肪肝的存在和严重程度的增加而直接增加。甘油三酯和肝酶天冬氨酸转氨酶和γ-谷氨酰转移酶（GGT）、基础胰岛素水平和稳态模型评估指数的水平也出现了类似情况。在多变量模型中，与 NAFLD 发生相关的变量是性别、甘油三酯和 GGT 水平以及肥胖。
预测 NAFLD 发生的主要因素是血液中的甘油三酯和 GGT 水平以及肥胖。肝脏脂肪堆积，加上肝水平的氧化和氧化应激增加，可能是这些因素增加 NAFLD 风险的机制。
