Fatty liver and chronic inflammation in Chinese adults

Objective: To investigate the significance of fatty liver as predictor of insulin resistance (IR) and chronic inflammation. Research design and methods: This cross-sectional study included 450 adults of Han Chinese origin aged >= 35. Excluded were cases with hepatitis B or C, alcoholic liver disease, or currently using thiazolidinedione. The volunteers were screened for the presence of the components of metabolic syndrome (MtS). IR index was estimated by the homeostasis model assessment. The fatty liver index was evaluated by computed tomography, calculated as the liver/spleen (US) ratio arrived at by averaging Hounsfield values obtained for five 3-mm slices. Serum levels of adiponectin, C-reactive protein (CRP), leptin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were checked in 100 subjects with low-L/S ratio and 100 age- and sex-matched controls. Results: Fatty liver index correlated with all MtS traits and IR index. The values of L/S ratios in subjects with 0, 1, 2, 3 and >= 4 traits of MtS were 1.25 +/- 0.13, 1.18 +/- 0.16, 1.12 +/- 0.21, 1.05 +/- 0.25 and 0.92 +/- 0.25, respectively (p < 0.001). In our stepwise regression analysis to compare the L/S ratios to the conventional traits of MtS for association with adipokine dysregulation, we found L/S ratio to be independently associated with most of them: adiponectin (p < 0.001), CRP (p < 0.001), IL-6 (p=0.005) and TNF-alpha (p=0.014). Conclusion: In Chinese, fatty liver index correlated well with IR index and can be a better marker of chronic inflammation than the conventional components of MtS. (C) 2008 Elsevier Ireland Ltd. All rights reserved.