1 Radiology Unit, National Institute for Digestive Disease , IRCCS "S. de Bellis," Castellana, Bari, Italy .
Metab Syndr Relat Disord. 2013 Oct;11(5):349-58. doi: 10.1089/met.2012.0169. Epub 2013 Jun 12.
The aim of this study was to evaluate the distribution of fatty liver-nonalcoholic (NAFL) and alcoholic (AFL)-and its association with metabolic syndrome and its components in a population sample from a Mediterranean area.
A sample of 2974 subjects (1679 males, 1295 females, age range 30-89 years) was randomly drawn from the population of a town in southern Italy. The survey visit included a validated semiquantitative food frequency questionnaire, anthropometric measurements, a blood sample taken in the morning after overnight fasting, as well as abdominal ultrasound examination to evaluate liver fat with a standardized scoring system. The 2001 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition of the metabolic syndrome was adopted.
In this Mediterranean population, where alcohol intake is mostly as wine with meals, NAFL is present in 36.8% of men and 25.7% of women and AFL in 13.8% of men and 5.5% of women. NAFL and AFL are associated with metabolic syndrome and its characteristics, body mass index (BMI), and visceral and subcutaneous fat (in AFL subjects, only in women) measured by ultrasound. Stratifying by BMI and controlling for confounders (age, height, smoking habit, and alcohol consumption), in overweight and obese subjects, liver and visceral fat are associated with the metabolic syndrome both in men and women and subcutaneous fat only in women. In normal weight subjects, only liver fat in men is associated with the metabolic syndrome.
Fatty liver is highly prevalent in this Mediterranean population and is associated with metabolic syndrome in overweight and obese men and women as well as in men with normal BMI.
本研究旨在评估非酒精性（NAFL）和酒精性（AFL）脂肪肝在一个来自地中海地区人群中的分布情况，并分析其与代谢综合征及其组分的相关性。
从意大利南部一个城镇的人群中随机抽取了 2974 名受试者（男性 1679 名，女性 1295 名，年龄 30-89 岁）作为样本。在调查访问中，受试者完成了一份经过验证的半定量食物频率问卷、人体测量学测量、空腹过夜后的次日早晨的血液样本采集，以及腹部超声检查以使用标准化评分系统评估肝脏脂肪。采用 2001 年国家胆固醇教育计划成人治疗专家组第三版（NCEP ATP III）代谢综合征定义。
在这个地中海人群中，酒精摄入主要以餐中葡萄酒的形式摄入，男性中 36.8%和女性中 25.7%存在 NAFL，男性中 13.8%和女性中 5.5%存在 AFL。NAFL 和 AFL 与代谢综合征及其特征、体重指数（BMI）以及通过超声测量的内脏和皮下脂肪（在 AFL 受试者中，仅女性中存在）相关。按 BMI 分层并控制混杂因素（年龄、身高、吸烟习惯和酒精摄入量）后，在超重和肥胖受试者中，肝脏和内脏脂肪与男性和女性的代谢综合征均相关，而皮下脂肪仅与女性相关。在正常体重受试者中，仅男性的肝脏脂肪与代谢综合征相关。
在这个地中海人群中，脂肪肝高度普遍，与超重和肥胖的男性和女性以及正常 BMI 的男性中的代谢综合征相关。
