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Fatty liver common despite absence of metabolic abnormalities
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LAS VEGAS — Moderate-to-severe hepatic steatosis was highly prevalent in a cohort of patients without metabolic syndrome, liver disease or other abnormalities in a study presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
Radiologists reviewed archived videos of 33,199 gallbladder ultrasounds performed during the National Health and Nutrition Examination Survey III between 1988 and 1994 to determine the presence of hepatic steatosis (HS). Only cases without metabolic syndrome (MetS) or elevated liver enzymes, plus those with liver ultrasound results reported at “absolute” or “absolute confident” levels after review were studied. That resulted in 5,562 cases.
“Hepatic steatosis is a common finding in individuals with nonalcoholic fatty liver disease [NAFLD],” the researchers wrote. “MetS has been identified as the most important risk factor for the development of NAFLD. [However,] the evaluation of HS in individuals without clear risk factors has not been studied well.”
Moderate or severe HS in the absence of chronic liver disease or excessive alcohol consumption was observed in 10.8% of cases, with higher prevalence among participants with a BMI of 30 or higher (18.0% of cases), diabetes (25.6%) or high triglyceride levels (17.9%). All were independently predictive of moderate-to-severe HS (adjusted OR=2.07; 95% CI, 1.60-2.67 for higher BMI; aOR=2.13; 95% CI, 1.24-3.64 for diabetes and aOR=1.68; 95% CI, 1.24-2.89 for high triglycerides). Patients without any of these predictors had an HS prevalence of 9.5%, including 7.2% for moderate cases and 2.3% for severe cases.
Raxitkumar Jinjuvadia
“Prevalence of NAFLD is very high, even among individuals without metabolic syndrome or any of its individual components,” researcher Raxitkumar Jinjuvadia, MD, MPH, Wayne State University/Detroit Medical Center and John D. Dingell VA Medical Center, told Healio.com. “We found that, even in those without MetS, fatty liver was present in [approximately] 9%. It is unclear how many of those will progress to steatohepatitis or cirrhosis. … Studies evaluating progression of these individuals [NAFLD without metabolic abnormalities] to liver-related complications will prove beneficial.”
For more information:
Jinjuvadia R. #33: Ultrasonographic Evidence of Hepatic Steatosis in Individuals Without Metabolic Syndrome. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.