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Cited by 2,679

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Nonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome

Open access
Marchesini, Giulio, Bugianesi, Elisabetta, Forlani, Gabriele, Cerrelli, Fernanda, Lenzi, Marco, Manini, Rita, Natale, Stefania, Vanni, Ester, Villanova, Nicola, Melchionda, Nazario, Rizzetto, Mario·2003·Hepatology
DOI 10.1053/jhep.2003.50161
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Abstract

Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin–resistance syndrome, at present defined as the metabolic syndrome, whose limits were recently set. We assessed the prevalence of the metabolic syndrome in 304 consecutive NAFLD patients without overt diabetes, on the basis of 3 or more criteria out of 5 defined by the U.S. National Institutes of Health (waist circumference, glucose, high–density lipoprotein [HDL]–cholesterol, triglycerides, and arterial pressure). The prevalence of the metabolic syndrome increased with increasing body mass index, from 18% in normal–weight subjects to 67% in obesity. Insulin resistance (Homeostasis Model Assessment method) was significantly associated with the metabolic syndrome (odds ratio [OR], 2.5; 95% CI, 1.5–4.2; P < .001). Liver biopsy was available in 163 cases (54%). A total of 120 patients (73.6%) were classified as having nonalcoholic steatohepatitis (NASH); 88% of them had a metabolic syndrome (vs. 53% of patients with pure fatty liver; P < .0001). Logistic regression analysis confirmed that the presence of metabolic syndrome carried a high risk of NASH among NAFLD subjects (OR, 3.2; 95% CI, 1.2–8.9; P = .026) after correction for sex, age, and body mass. In particular, the syndrome was associated with a high risk of severe fibrosis (OR, 3.5; 95% CI, 1.1–11.2; P = .032). In conclusion, the presence of multiple metabolic disorders is associated with a potentially progressive, severe liver disease. The increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension, and ultimately the metabolic syndrome puts a very large population at risk of forthcoming liver failure in the next decades. (Hepatology 2003;37:917–923.)

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Metadata

Authors
Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., & Rizzetto, M.
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-04
Volume
37
Issue
4
Pages
917-923
ISSN
0270-9139 (ISSN-L)
DOI
10.1053/jhep.2003.50161
OpenAlex
W2164118055
Cited by
2,679
References
6
FWCI
59.64
Type
journal article
Language
en
Open access
bronze

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