Nonalcoholic Fatty Liver Disease and Abnormal Liver Function Test in the Health Screen Examinees: the Relationship with Insulin Resistance

Park, Seung Ha; Kim, Byung Ik; Yoo, Tae Woo; Kim, Jeong Wook; Cho, Yong Kyun; Sung, In Kyung; Park, Chang Young; Sohn, Chong Il; Jeon, Woo Kyu; Lee, Won Young; Kim, Sun Woo

Abstract

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) is one of the major causes of the elevation of aminotransferase when other causes of liver disease are excluded. Insulin resistance is an essential pathophysiologic factor in the development of NAFLD and metabolic syndrome. We hypothesized that there would be an association between the elevation of aminotransferase and metabolic syndrome. METHODS: A total of 6,244 health screen examinees (3,975 men, 2,269 women) with no evidence of viral hepatitis and alcohol abuse were enrolled in this study. We assessed the clinical characteristics using liver function test (LFT) and ultrasonography. Homeostatic model assessment (HOMA) was used as an index of insulin resistance. RESULTS: According to the increment of HOMA, the prevalence of abnormal liver function significantly increased after adjustment with age, sex, and obesity (p<0.01). Abnormal liver function remained as an independent risk factor for metabolic syndrome in both sexes after logistic multiple regression analysis with age and body mass index (p<0.001 in male, p<0.05 in female). CONCLUSIONS: The abnormal liver function was closely associated with insulin resistance. Thus, it can be an independent risk factor for metabolic syndrome. Index of insulin resistance such as HOMA may serve as a good parameter for follow-up during the treatment of NAFLD.