Impact of Visceral Fat on the Metabolic Syndrome and Nonalcoholic Fatty Liver Disease

다국어 초록 (Multilingual Abstract)

Visceral fat has been reported to be associated with nonalcoholic fatty liver disease

(NAFLD) and the metabolic syndrome (MetS). We assessed the prevalence of both

NAFLD and the MetS, measured visceral fat thickness (VFT), and estimated the

physical activity indexes of 224 relatively healthy hospital workers. We also investigated

the associations between both VFT and physical activity index and each of

NAFLD and the MetS. The MetS was diagnosed according to the guidelines outlined

by the Adult Treatment Panel III, and NAFLD was diagnosed by ultrasonography.

Subjects with hepatitis B and C infections and those reporting moderate

alcohol consumption were excluded from the study. The prevalence of the MetS

was 11.6% and that of NAFLD was 41.5%. Many subjects with the MetS had NAFLD

(73.1%), and some subjects with NAFLD (20.4%) also had several components of

the MetS (p=0.001). VFT was significantly increased by both the addition of components

of the MetS and the severity of NAFLD (p<0.001). In addition, VFT was

independently associated with NAFLD (odds ratio [OR], 1.10; 95% confidence interval

[CI], 1.02-1.19) in subjects with more than 2 components of the MetS. In contrast,

habitual physical activity was reversely associated with NAFLD (OR, 0.29;

95% CI, 0.10-0.87). In conclusion, an increased visceral fat content and reduced

physical activity could be not only biological markers but also therapeutic targets in

the treatment of NAFLD and the MetS.

참고문헌 (Reference)

1 김수연, "종합검진 수진자에서 비알콜성 지방간과 대사 증후군의 연관성" 대한가정의학회 28 (28): 667-674, 2007

2 이위교, "임상검사실 표준화 심사 및 신임 인증제도에 관한 연구 Ⅱ: 1차년도 인증심사 분석" 대한진단검사의학회 23 (23): 363-369, 2003

3 Banfi C, "Very low density lipoprotein-mediated signal transduction and plasminogen activator inhibitor type 1 in cultured HepG2 cells" 85 : 208-217, 1999

4 Andrade S, "Use of a Durnin-Womersley formula to estimate change in subcutaneous fat content in HIV-infected subjects" 75 : 587-592, 2002

5 Yajima Y, "Ultrasonographical diagnosis of fatty liver: significance of the liver-kidney contrast" 139 : 43-50, 1983

6 Saadeh S, "The utility of radiological imaging in nonalcoholic fatty liver disease" 123 : 745-750, 2002

7 Hamaguchi M, "The metabolic syndrome as a predictor of nonalcoholic fatty liver disease" 143 : 722-728, 2005

8 Barzilai N, "Surgical removal of visceral fat reverses hepatic insulin resistance" 48 : 94-98, 1999

9 Ford ES, "Sedentary behavior, physical activity, and the metabolic syndrome among U.S. adults" 13 : 608-614, 2005

10 Bedogni G, "Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study" 42 : 44-52, 2005

11 Bellentani S, "Prevalence of and risk factors for hepatic steatosis in Northern Italy" 132 : 112-117, 2000

12 Roskams T, "Oxidative stress and oval cell accumulation in mice and humans with alcoholic and nonalcoholic fatty liver disease" 163 : 1301-1311, 2003

13 Targher G, "Nonalcoholic hepatic steatosis and its relation to increased plasma biomarkers of inflammation and endothelial dysfunction in non-diabetic men. Role of visceral adipose tissue" 22 : 1354-1358, 2005

14 Marchesini G, "Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome" 37 : 917-923, 2003

15 Onat A, "Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels--a prospective and cross-sectional evaluation" 165 : 285-292, 2002

16 Laaksonen DE, "Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study" 156 : 1070-1077, 2002

17 Jeong SK, "Metabolic syndrome and ALT: a community study in adult Koreans" 28 : 1033-1038, 2004

18 Samuel VT, "Mechanism of hepatic insulin resistance in nonalcoholic fatty liver disease" 279 : 32345-32353, 2004

19 Woo J, "Influence of educational level and marital status on dietary intake, obesity and other cardiovascular risk factors in a Hong Kong Chinese population" 53 : 461-467, 1999

20 Furukawa S, "Increased oxidative stress in obesity and its impact on metabolic syndrome" 114 : 1752-1761, 2004

21 Bedogni G, "Fatty liver: how frequent is it and why?" 3 : 63-65, 2004

22 "Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)" 285 : 2486-2497, 2001

23 O’Leary VB, "Exercise-induced reversal of insulin resistance in obese elderly is associated with reduced visceral fat" 100 : 1584-1589, 2006

24 Kim DS, "Effects of triglyceride on ER stress and insulin resistance" 363 : 140-145, 2007

25 Hae-Sung Nam, "Does Waist Indicate Dyslipidemia better than BMI in Korean Adult Population?" 대한의학회 20 (20): 7-12, 2005

26 Grundy SM, "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement" 112 : 2735-2752, 2005

27 Quinn SF, "Characteristic sonographic signs of hepatic fatty infiltration" 145 : 753-755, 1985

28 Isomaa B, "Cardiovascular morbidity and mortality associated with the metabolic syndrome" 24 : 683-689, 2001

29 Durnin JV, "Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years" 32 : 77-97, 1974

30 Lee CW, "Ahn EJ. Measurement properties of Baecke’s habitual physical activity questionnaire and related variables" 18 : 38-53, 1992

31 Sanyal AJ, "AGA technical review on nonalcoholic fatty liver disease" 123 : 1705-1725, 2002

32 Baecke JA, "A short questionnaire for the measurement of habitual physical activity in epidemiological studies" 36 : 936-942, 1982