Comparison of characteristics between nonobese and overweight/obese subjects with nonalcoholic fatty liver disease in a South Indian population.

AIMS

This study was designed to compare the characteristics of nonobese and overweight/obese subjects with nonalcoholic fatty liver disease (NAFLD) in an urban South Indian population.

SUBJECTS AND METHODS

The study group comprises 541 subjects drawn from the Chennai Urban Rural Epidemiology Study (CURES), which was carried out on a representative sample of Chennai city in southern India. NAFLD was diagnosed by ultrasonography. Subjects with NAFLD were classified as nonobese (body mass index of ≤22.9 kg/m(2)) and overweight/obese (body mass index of ≥23 kg/m(2)) based on World Health Organization Asia Pacific guidelines. Coronary artery disease (CAD) was assessed by a resting 12-lead electrocardiogram that was Minnesota-coded. Insulin resistance was assessed by using the homeostasis assessment model (HOMA-IR) using the following formula: fasting insulin (μIU/mL)×fasting glucose (mmol/L)/22.5.

RESULTS

In total, 173 of 541 (32%) subjects had NAFLD, of whom 48 (27.7%) had nonobese NAFLD and 125 (72.3%) had overweight/obese NAFLD. Compared with overweight/obese NAFLD patients, fasting blood glucose (104±29 vs. 119±45 mg/dL; P<0.05) and HOMA-IR (2.1±1.8 vs. 2.9±1.8; P<0.001) were lower and high-density lipoprotein cholesterol (43±9 vs. 39±8 mg/dL; P<0.001) was higher among nonobese NAFLD subjects. Multiple logistic regression analysis showed a significant association between nonobese NAFLD and CAD (P=0.013) even after adjusting for age, diabetes, hypercholesterolemia, HOMA-IR, and hypertension.

CONCLUSIONS

This study suggests that even nonobese NAFLD subjects have an association with CAD.