The roles of obesity and gender on the relationship between metabolic risk factors and non-alcoholic fatty liver disease in Koreans

Abstract

Background: The effect of gender and weight status on the association between metabolic risk factors and NAFLD has not been well established. This study aimed to assess the relationships among obesity, gender, metabolic risk factors, and non-alcoholic fatty liver disease (NAFLD) in Korean adults.

Methods: Abdominal ultrasounds, anthropometric measurements, and biochemical tests were performed on 13,768 Korean adults (7,313 men and 6,455 women) recruited from a health promotion centre between 2005 and 2006.

Results: Of 13,768 subjects, 25% were diagnosed with NAFLD. Weight status (obesity vs non-obesity, odds ratio (OR) 4.4-9.7) and gender (women vs men, OR 0.6) were associated with NAFLD after adjusting for age, metabolic risk factors (high blood pressure, high glucose, high TG, low HDL, high LDL, and high uric acid), and gamma-glutamyl transferase (gammaGT). For subjects with any one risk factor, the OR (95% CI) for mild fatty liver was 27 (19.3-37.8) in men and 7.9 (6.1-10.2) in women who were obese compared to non-obese individuals having no risk factors. The ORs in men and women who were not obese were 4.7 (3.9-5.6) and 2.5 (2.2-3.0), respectively. The sensitivity and specificity for NAFLD with any one risk factor without obesity was 90-91 and 32-49%, respectively; any one risk factor combined with obesity changed the sensitivity and specificity to 64-67 and 77-85%, respectively.

Conclusions: Gender and weight status appear to modify the relationship between metabolic risk factors and NAFLD.