Anna Kotronen,
Jukka Westerbacka,
Robert Bergholm,
Kirsi H. Pietiläinen and
Hannele Yki-Järvinen
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 ofthe metabolic syndrome, such as glucose and lipids. The amountof liver fat in subjects with and without the metabolic syndromehas not been determined. It is unknown which clinically availablemarkers best reflect liver fat content.
Measurements: Components of the metabolic syndrome as definedby the International Diabetes Federation and liver fat contentby proton magnetic resonance spectroscopy were measured in 271nondiabetic subjects (162 women, 109 men). In addition, otherfeatures of insulin resistance (serum insulin, C-peptide), intraabdominaland 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 metabolicsyndrome. This increase in liver fat remained significant afteradjusting for age, gender, and body mass index. All componentsof 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 correlatedsignificantly with serum alanine aminotransferase (r = 0.39,P < 0.0001 for women; r = 0.44, P < 0.0001 for men) andaspartate aminotransferase (r = 0.27, P = 0.0005 for women;r = 0.31, P = 0.0012 for men) concentrations. The best correlatesof liver fat were fasting serum insulin (r = 0.61; P < 0.0001for both women and men) and C-peptide (r = 0.62; P < 0.0001for both women and men).
Conclusions: Liver fat content is significantly increased insubjects with the metabolic syndrome as compared with thosewithout the syndrome, independently of age, gender, and bodymass index. Of other markers, serum C-peptide is the strongestcorrelate of liver fat.
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