This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kotronen, A. Articles by Yki-Järvinen, H. Search for Related Content PubMed PubMed Citation Articles by Kotronen, A. Articles by Yki-Järvinen, H. Related Collections Diabetes and Insulin Metabolism Obesity

Liver Fat in the Metabolic Syndrome

Department of Medicine (A.K., J.W., R.B., K.H.P., H.Y.-J.), Division of Diabetes, The Finnish Twin Cohort Study, Department of Public Health (K.H.P.), and Obesity Research Unit (K.H.P.), Department of Psychiatry, University of Helsinki, FIN-00029 Helsinki, Finland; and Minerva Medical Research Institute (A.K., R.B.), 00290 Helsinki, Finland

Address all correspondence and requests for reprints to: Hannele Yki-Järvinen, M.D., F.R.C.P., Department of Medicine, Division of Diabetes, University of Helsinki, Finland, P.O. Box 700, Room C426B, FIN-00029 HUCH, Helsinki, Finland. E-mail: ykijarvi{at}cc.helsinki.fi.

Background: The liver, once fatty, overproduces components of the metabolic syndrome, such as glucose and lipids. The amount of liver fat in subjects with and without the metabolic syndrome has not been determined. It is unknown which clinically available markers best reflect liver fat content.

Measurements: Components of the metabolic syndrome as defined by the International Diabetes Federation and liver fat content by proton magnetic resonance spectroscopy were measured in 271 nondiabetic subjects (162 women, 109 men). In addition, other features of insulin resistance (serum insulin, C-peptide), intraabdominal and sc fat by magnetic resonance imaging, and liver enzymes (serum alanine aminotransferase and serum aspartate aminotransferase) were measured.

Results: Liver fat was 4-fold higher in subjects with [n = 116; median 8.2% (interquartile range 3.2–18.7%)] than without [n = 155; 2.0% (1.0–5.0%); P < 0.0001] the metabolic syndrome. This increase in liver fat remained significant after adjusting for age, gender, and body mass index. All components of the metabolic syndrome correlated with liver fat content. The best correlate was waist in both women (r = 0.59, P < 0.0001) and men (r = 0.56, P < 0.0001). Liver fat correlated significantly with serum alanine aminotransferase (r = 0.39, P < 0.0001 for women; r = 0.44, P < 0.0001 for men) and aspartate aminotransferase (r = 0.27, P = 0.0005 for women; r = 0.31, P = 0.0012 for men) concentrations. The best correlates of liver fat were fasting serum insulin (r = 0.61; P < 0.0001 for both women and men) and C-peptide (r = 0.62; P < 0.0001 for both women and men).

Conclusions: Liver fat content is significantly increased in subjects with the metabolic syndrome as compared with those without the syndrome, independently of age, gender, and body mass index. Of other markers, serum C-peptide is the strongest correlate of liver fat.

This article has been cited by other articles:

				K D Bruce and C D Byrne The metabolic syndrome: common origins of a multifactorial disorder Postgrad. Med. J., November 1, 2009; 85(1009): 614 - 621. [Abstract] [Full Text] [PDF]

				J. M. Petit, B. Guiu, B. Terriat, R. Loffroy, I. Robin, V. Petit, B. Bouillet, M.-C. Brindisi, L. Duvillard, P. Hillon, et al. Nonalcoholic Fatty Liver Is Not Associated with Carotid Intima-Media Thickness in Type 2 Diabetic Patients J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 4103 - 4106. [Abstract] [Full Text] [PDF]

				A. Kotronen, H. Yki-Jarvinen, A. Aminoff, R. Bergholm, K. H Pietilainen, J. Westerbacka, P. J Talmud, S. E Humphries, A. Hamsten, B. Isomaa, et al. Genetic variation in the ADIPOR2 gene is associated with liver fat content and its surrogate markers in three independent cohorts Eur. J. Endocrinol., April 1, 2009; 160(4): 593 - 602. [Abstract] [Full Text] [PDF]

				E. J CHURCH Imaging Diabetes Radiol. Technol., March 1, 2009; 80(4): 340 - 360. [Abstract] [Full Text] [PDF]

				N. Stefan, K. Kantartzis, and H.-U. Haring Causes and Metabolic Consequences of Fatty Liver Endocr. Rev., December 1, 2008; 29(7): 939 - 960. [Abstract] [Full Text] [PDF]

				M.-A. Cornier, D. Dabelea, T. L. Hernandez, R. C. Lindstrom, A. J. Steig, N. R. Stob, R. E. Van Pelt, H. Wang, and R. H. Eckel The Metabolic Syndrome Endocr. Rev., December 1, 2008; 29(7): 777 - 822. [Abstract] [Full Text] [PDF]

				A. Kotronen, M. Lewitt, K. Hall, K. Brismar, and H. Yki-Jarvinen Insulin-Like Growth Factor Binding Protein 1 as a Novel Specific Marker of Hepatic Insulin Sensitivity J. Clin. Endocrinol. Metab., December 1, 2008; 93(12): 4867 - 4872. [Abstract] [Full Text] [PDF]

				H. R. Song, K. E. Yun, and H. S. Park Relation between alanine aminotransferase concentrations and visceral fat accumulation among nondiabetic overweight Korean women Am. J. Clinical Nutrition, July 1, 2008; 88(1): 16 - 21. [Abstract] [Full Text] [PDF]

				K. Sevastianova, J. Sutinen, K. Kannisto, A. Hamsten, M. Ristola, and H. Yki-Jarvinen Adipose tissue inflammation and liver fat in patients with highly active antiretroviral therapy-associated lipodystrophy Am J Physiol Endocrinol Metab, July 1, 2008; 295(1): E85 - E91. [Abstract] [Full Text] [PDF]

				D. Greco, A. Kotronen, J. Westerbacka, O. Puig, P. Arkkila, T. Kiviluoto, S. Laitinen, M. Kolak, R. M. Fisher, A. Hamsten, et al. Gene expression in human NAFLD Am J Physiol Gastrointest Liver Physiol, May 1, 2008; 294(5): G1281 - G1287. [Abstract] [Full Text] [PDF]

				L. Juurinen, A. Kotronen, M. Graner, and H. Yki-Jarvinen Rosiglitazone Reduces Liver Fat and Insulin Requirements and Improves Hepatic Insulin Sensitivity and Glycemic Control in Patients with Type 2 Diabetes Requiring High Insulin Doses J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 118 - 124. [Abstract] [Full Text] [PDF]

				A. Kotronen, L. Juurinen, A. Hakkarainen, J. Westerbacka, A. Corner, R. Bergholm, and H. Yki-Jarvinen Liver Fat Is Increased in Type 2 Diabetic Patients and Underestimated by Serum Alanine Aminotransferase Compared With Equally Obese Nondiabetic Subjects Diabetes Care, January 1, 2008; 31(1): 165 - 169. [Abstract] [Full Text] [PDF]

				A. Kotronen, S. Vehkavaara, A. Seppala-Lindroos, R. Bergholm, and H. Yki-Jarvinen Effect of liver fat on insulin clearance Am J Physiol Endocrinol Metab, December 1, 2007; 293(6): E1709 - E1715. [Abstract] [Full Text] [PDF]