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.
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Abbreviations
- AF:
-
Advanced fibrosis
- AST:
-
Aspartate aminotransferase
- ALT:
-
Alanine aminotransferase
- APRI:
-
AST to Platelet Ratio Index
- BMI:
-
Body mass index
- CDC:
-
Centers for Disease Control and Prevention
- DALYs:
-
Disability-adjusted life years
- FIB-4:
-
Fibrosis-4
- GGT:
-
γ-Glutamyl transpeptidase
- HDL:
-
High-density lipoprotein
- HbA1c:
-
Hemoglobin A1c
- HCC:
-
Hepatocellular carcinoma
- IDF:
-
International Diabetes Federation
- LDL:
-
Low-density lipoprotein
- LD:
-
Liver disease
- LT:
-
Liver transplantation
- MetS:
-
Metabolic syndrome
- NHANES:
-
National Health and Nutrition Examination Survey
- NAFLD:
-
Nonalcoholic fatty liver disease
- NCHS:
-
National Center for Health Statistics
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AS, NA, and AM contributed to study concept and design; AS performed acquisition of data; AS and RL analyzed and interpreted the data; all authors drafted and critically revised the manuscript for important intellectual content; RL, AS, NA, and AM performed statistical analysis; all authors provided administrative, technical, or material support; NA and AM supervised the study.
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Amandeep Singh, Hina Amin, Mohit Gupta, Rocio Lopez, and Naim Alkhouri have no conflict of interest and nothing to disclose.
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Singh, A., Amin, H., Garg, R. et al. Increased Prevalence of Obesity and Metabolic Syndrome in Patients with Alcoholic Fatty Liver Disease. Dig Dis Sci 65, 3341–3349 (2020). https://doi.org/10.1007/s10620-020-06056-1
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DOI: https://doi.org/10.1007/s10620-020-06056-1