Increased Prevalence of Obesity and Metabolic Syndrome in Patients with Alcoholic Fatty Liver Disease
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ORIGINAL ARTICLE
Increased Prevalence of Obesity and Metabolic Syndrome in Patients with Alcoholic Fatty Liver Disease Amandeep Singh1 · Hina Amin1 · Rajat Garg2 · Mohit Gupta2 · Rocio Lopez3 · Naim Alkhouri4 · Arthur MCCullough1,5 Received: 27 June 2019 / Accepted: 7 January 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background and Aims Obesity and diabetes are risk factors for advanced alcoholic liver disease, and both are components of the metabolic syndrome. We aimed to assess the prevalence of metabolic syndrome and its components in a contemporary US cohort of adults with alcoholic liver disease and compare it to a historic cohort to assess changes over time. Method Individuals 18 years or older who participated in the National Health and Nutrition Examination Survey during 2009–2014 and 1999–2001 were used as the contemporary and historic cohort, respectively. Alcoholic liver disease was defined as excessive alcohol consumption (men: ≥ 3 drinks/day; women: ≥ 2 drinks/day) and elevated alanine aminotransferase. Metabolic syndrome definition was based on the updated International Diabetes Federation criteria. Data are presented as mean ± standard error or unweighted frequency. A logistic regression analysis was performed to assess differences in metabolic syndrome components between the two period cohorts while adjusting for central obesity. Results The mean age for our contemporary cohort was 41.9, 66.1% being male. Central obesity was present in 66.3%, type 2 diabetes in 18.7%, low high-density lipoprotein in 28.3%, hypertriglyceridemia in 44.8%, and hypertension in 54.7%. 36.9% met the criteria for metabolic syndrome. Compared to the historic cohort, patients in the contemporary cohort were more likely to have central obesity (50% vs. 66%, p = 0.002), metabolic syndrome (26% vs. 37%, p = 0.044), and type 2 diabetes (12% vs. 19%, p = 0.099). Conclusions Prevalence of both obesity and metabolic syndrome is increasing in alcoholic liver disease patients. Further studies are required to investigate effective interventions to avoid disease progression in these high-risk patients. Keywords Alcoholic liver disease · Metabolic syndrome · Obesity
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06056-1) contains supplementary material, which is available to authorized users. * Amandeep Singh [email protected] Hina Amin [email protected] Mohit Gupta [email protected] Rocio Lopez [email protected] Naim Alkhouri [email protected] Arthur MCCullough [email protected]
Abbreviations AF Advanced fibrosis AST Aspartate aminotransferase ALT Alanine aminotransferase APRI AST to Platelet Ratio Index 1
Department of Gastroenterology and Hepatology, Center for Human Nutrition, Digestive Diseases and Surgery Institute, A5 ANNEX, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
2
Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA
3
Center for Populations Health Sciences and
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