Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age-dependent risk profiling study

Salvatore Petta, Mohammed Eslam, Luca Valenti, Elisabetta Bugianesi, Marco Barbara, Calogero Cammà, Marianna Porzio, Chiara Rosso, Silvia Fargion, Jacob George, Antonio Craxì

Research output: Contribution to journalArticle

Abstract

Background & Aims: Metabolic syndrome (MS) and its individual components are associated with the severity and progression of nonalcoholic fatty liver disease (NAFLD). We sought to evaluate the relationship between MS components and the risk of severe hepatic fibrosis in NAFLD patients discriminated by age. Methods: We considered 863 consecutive patients with biopsy-proven NAFLD, who had been fully evaluated for components of MS. Results: Multivariate logistic regression analysis showed that F3-F4 was associated with visceral obesity, IFG/diabetes, and low high-density lipoprotein (HDL) cholesterol, but not triglycerides >150 or arterial hypertension. A significant interaction was found between age and visceral obesity (P=.04). By stratifying patients for age, we confirmed the interaction between inclusion in the third age tertile (>54 years) and visceral obesity (P=.04). In the lower (<41 years) and middle (41-54 years) age tertiles, the risk for F3-F4 fibrosis was mostly driven by visceral obesity and IFG/diabetes. This risk was higher in those with all three metabolic risk factors. Finally, among patients in the higher age tertile (>54 years), obesity did not affect the severity of fibrosis, and the risk of severe fibrosis was higher in those with low HDL and IFG/diabetes with/without visceral obesity (52%-54%). Conclusions: Among patients with NAFLD, the metabolic profiles associated with risk for severe fibrosis varied among age groups. Low HDL, obesity and IFG/diabetes were prevalent among patients in the lower and middle age tertiles. HDL and IFG/diabetes but not visceral obesity were prevalent among those in the highest age tertile.

Original languageEnglish
Pages (from-to)1389-1396
Number of pages8
JournalLiver International
Volume37
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Abdominal Obesity
Fibrosis
HDL Lipoproteins
LDL Lipoproteins
Obesity
Metabolome
LDL Cholesterol
HDL Cholesterol
Triglycerides
Age Groups
Logistic Models
Regression Analysis
Non-alcoholic Fatty Liver Disease
Hypertension
Biopsy
Liver

Keywords

  • diabetes
  • metabolic syndrome
  • nonalcoholic fatty liver disease
  • obesity

ASJC Scopus subject areas

  • Hepatology

Cite this

Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease : An age-dependent risk profiling study. / Petta, Salvatore; Eslam, Mohammed; Valenti, Luca; Bugianesi, Elisabetta; Barbara, Marco; Cammà, Calogero; Porzio, Marianna; Rosso, Chiara; Fargion, Silvia; George, Jacob; Craxì, Antonio.

In: Liver International, Vol. 37, No. 9, 01.09.2017, p. 1389-1396.

Research output: Contribution to journalArticle

Petta, S, Eslam, M, Valenti, L, Bugianesi, E, Barbara, M, Cammà, C, Porzio, M, Rosso, C, Fargion, S, George, J & Craxì, A 2017, 'Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease: An age-dependent risk profiling study', Liver International, vol. 37, no. 9, pp. 1389-1396. https://doi.org/10.1111/liv.13397
Petta, Salvatore ; Eslam, Mohammed ; Valenti, Luca ; Bugianesi, Elisabetta ; Barbara, Marco ; Cammà, Calogero ; Porzio, Marianna ; Rosso, Chiara ; Fargion, Silvia ; George, Jacob ; Craxì, Antonio. / Metabolic syndrome and severity of fibrosis in nonalcoholic fatty liver disease : An age-dependent risk profiling study. In: Liver International. 2017 ; Vol. 37, No. 9. pp. 1389-1396.
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AU - Eslam, Mohammed

AU - Valenti, Luca

AU - Bugianesi, Elisabetta

AU - Barbara, Marco

AU - Cammà, Calogero

AU - Porzio, Marianna

AU - Rosso, Chiara

AU - Fargion, Silvia

AU - George, Jacob

AU - Craxì, Antonio

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N2 - Background & Aims: Metabolic syndrome (MS) and its individual components are associated with the severity and progression of nonalcoholic fatty liver disease (NAFLD). We sought to evaluate the relationship between MS components and the risk of severe hepatic fibrosis in NAFLD patients discriminated by age. Methods: We considered 863 consecutive patients with biopsy-proven NAFLD, who had been fully evaluated for components of MS. Results: Multivariate logistic regression analysis showed that F3-F4 was associated with visceral obesity, IFG/diabetes, and low high-density lipoprotein (HDL) cholesterol, but not triglycerides >150 or arterial hypertension. A significant interaction was found between age and visceral obesity (P=.04). By stratifying patients for age, we confirmed the interaction between inclusion in the third age tertile (>54 years) and visceral obesity (P=.04). In the lower (<41 years) and middle (41-54 years) age tertiles, the risk for F3-F4 fibrosis was mostly driven by visceral obesity and IFG/diabetes. This risk was higher in those with all three metabolic risk factors. Finally, among patients in the higher age tertile (>54 years), obesity did not affect the severity of fibrosis, and the risk of severe fibrosis was higher in those with low HDL and IFG/diabetes with/without visceral obesity (52%-54%). Conclusions: Among patients with NAFLD, the metabolic profiles associated with risk for severe fibrosis varied among age groups. Low HDL, obesity and IFG/diabetes were prevalent among patients in the lower and middle age tertiles. HDL and IFG/diabetes but not visceral obesity were prevalent among those in the highest age tertile.

AB - Background & Aims: Metabolic syndrome (MS) and its individual components are associated with the severity and progression of nonalcoholic fatty liver disease (NAFLD). We sought to evaluate the relationship between MS components and the risk of severe hepatic fibrosis in NAFLD patients discriminated by age. Methods: We considered 863 consecutive patients with biopsy-proven NAFLD, who had been fully evaluated for components of MS. Results: Multivariate logistic regression analysis showed that F3-F4 was associated with visceral obesity, IFG/diabetes, and low high-density lipoprotein (HDL) cholesterol, but not triglycerides >150 or arterial hypertension. A significant interaction was found between age and visceral obesity (P=.04). By stratifying patients for age, we confirmed the interaction between inclusion in the third age tertile (>54 years) and visceral obesity (P=.04). In the lower (<41 years) and middle (41-54 years) age tertiles, the risk for F3-F4 fibrosis was mostly driven by visceral obesity and IFG/diabetes. This risk was higher in those with all three metabolic risk factors. Finally, among patients in the higher age tertile (>54 years), obesity did not affect the severity of fibrosis, and the risk of severe fibrosis was higher in those with low HDL and IFG/diabetes with/without visceral obesity (52%-54%). Conclusions: Among patients with NAFLD, the metabolic profiles associated with risk for severe fibrosis varied among age groups. Low HDL, obesity and IFG/diabetes were prevalent among patients in the lower and middle age tertiles. HDL and IFG/diabetes but not visceral obesity were prevalent among those in the highest age tertile.

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