Clinical—Liver, Pancreas, and Biliary TractPrediction of Non-Alcoholic Fatty Liver Disease and Liver Fat Using Metabolic and Genetic Factors
Section snippets
Subjects and Study Design
All subjects (359 non-diabetic and 111 type 2 diabetic Finnish individuals) were recruited for metabolic studies designed to include either non-diabetic subjects12, 13, 14, 15, 16, 17 or type 2 diabetic patients18, 19, 20, 21 mainly by newspaper advertisements, by contacting occupational health services, or among subjects referred to the Department of Gastroenterology because of chronically elevated serum transaminase concentrations using the following inclusion criteria: (1) age 18–75 years;
Univariate Analyses of Determinants of Liver Fat in NAFLD
Of the study subjects, 51% had NAFLD (liver fat content ≥5.56%29), 57% had the metabolic syndrome, and 24% had type 2 diabetes. In univariate logistic regression analyses, increased liver fat content was associated with increased prevalence of the metabolic syndrome and type 2 diabetes, age, BMI, waist circumference, systolic and diastolic BP, fP-glucose, fS-triglyceride, fS-insulin, fS-ALT and fS-AST concentrations, and a decreased fS-HDL cholesterol concentration and AST/ALT ratio (Table 2).
Discussion
We have developed an NAFLD liver fat score, which allows identification of NAFLD using easily available clinical and laboratory data. Our cohort included 470 well-characterized Finnish individuals in whom liver fat content was measured using state-of-the-art 1H-MRS methodology.7 Knowledge of the metabolic syndrome; type 2 diabetes; and serum insulin, AST, and ALT concentrations allowed prediction of NAFLD with a sensitivity of 86% and a specificity of 71%. The score gave high values also in
Acknowledgments
The authors thank Anja Cornér, Juha Halavaara, Anna-Maija Häkkinen, Leena Juurinen, Jaakko Kaprio, Jesper Lundbom, Janne Makkonen, Sari Mäkimattila, Kirsi H. Pietiläinen, Leena Ryysy, Anneli Seppälä-Lindroos, Anssi Sovijärvi, Jussi Sutinen, Marjo Tamminen, Kari Teramo, Mirja Tiikkainen, Satu Vehkavaara, and Jukka Westerbacka for their contributions and Mia Urjansson, Katja Sohlo, Kaisa Makkonen, Tuija Mård, and Pentti Pölönen for excellent technical assistance.
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by research grants from the Academy of Finland (to H.Y.-J.); the Sigrid Juselius Foundation (to H.Y.-J.); the Novo Nordisk Foundation (to H.Y.-J., M.R.); the Biomedicum Helsinki Foundation (to A.K.); the Paulo Foundation (to A.K.); the Wallenberg Foundation (to L.G.); a Nordic Centre of Excellence in Disease Genetics grant by the Nordic Research Councils (to L.G.); the Swedish Research Council, Region Skåne (to M.R.); Påhlsson Foundation (to M.R.); the UMAS Foundation (to M.R.); the Swedish Diabetes Foundation (to M.R.); the Crafoord Foundation (to M.R.); the Lundgren Foundation (to M.R.); the Bergvall Foundation (to M.R.); and the European Commission as an Integrated Project under the 6th Framework Programme (contract LSHM-CT-2005-018734) (to H.Y.-J.) as part of the project “Hepatic and adipose tissue and functions in the metabolic syndrome (www.hepadip.org).