Comparison of Characteristics Between Nonobese and Overweight/Obese Subjects with Nonalcoholic Fatty Liver Disease in a South Indian Population

Aims: This study was designed to compare the characteristics of nonobese and overweight/obese subjects with nonalcoholic fatty liver disease (NAFLD) in an urban South Indian population. Subjects and Methods: The study group comprises 541 subjects drawn from the Chennai Urban Rural Epidemiology Study (CURES), which was carried out on a representative sample of Chennai city in southern India. NAFLD was diagnosed by ultrasonography. Subjects with NAFLD were classified as nonobese (body mass index of 22.9 kg/m(2)) and overweight/obese (body mass index of 23 kg/m(2)) based on World Health Organization Asia Pacific guidelines. Coronary artery disease (CAD) was assessed by a resting 12-lead electrocardiogram that was Minnesota-coded. Insulin resistance was assessed by using the homeostasis assessment model (HOMA-IR) using the following formula: fasting insulin (IU/mL)xfasting glucose (mmol/L)/22.5. Results: In total, 173 of 541 (32%) subjects had NAFLD, of whom 48 (27.7%) had nonobese NAFLD and 125 (72.3%) had overweight/obese NAFLD. Compared with overweight/obese NAFLD patients, fasting blood glucose (10429 vs. 119 +/- 45mg/dL; P<0.05) and HOMA-IR (2.1 +/- 1.8 vs. 2.9 +/- 1.8; P<0.001) were lower and high-density lipoprotein cholesterol (43 +/- 9 vs. 39 +/- 8mg/dL; P<0.001) was higher among nonobese NAFLD subjects. Multiple logistic regression analysis showed a significant association between nonobese NAFLD and CAD (P=0.013) even after adjusting for age, diabetes, hypercholesterolemia, HOMA-IR, and hypertension. Conclusions: This study suggests that even nonobese NAFLD subjects have an association with CAD.