Metabolic syndrome predicts the incidence of hepatic steatosis in Koreans

SummaryProblemIt has not been well elucidated whether the development of metabolic syndrome and its components predicts the incidence of hepatic steatosis.MethodsA cohort of 1705 apparently healthy Korean adults (954 men and 751 women, 43.6 ± 8.5 years old) without ultrasonographically defined hepatic steatosis and with normal serum gamma-glutamyl-transpeptidase and alanine aminotransferase was followed from 2004 to 2007. Metabolic syndrome was defined as the presence of at least three of the following components: obesity (BMI ≥ 25.0 kg/m2), high blood pressure, elevated levels of triglycerides and fasting glucose, and low level of high-density lipoprotein cholesterol. The outcome was ultrasonographically diagnosed hepatic steatosis. The analyses were conducted using the Cox proportional hazards model and time-dependent Cox model.ResultsA total of 226 individuals developed hepatic steatosis during 3716 person–years of follow-up. The presence of one to two metabolic syndrome components at baseline significantly predicted the development of hepatic steatosis. Metabolic syndrome itself, having ≥1 metabolic syndrome components, and maintenance of metabolic syndrome during follow-up significantly increased the risk (hazard ratio 2.0–4.1 for men, 3.4–10.8 for women) after adjustment for the follow-up period, age and BMI at baseline or updated during follow-up. Occurrence of obesity, high triglycerides or high fasting glucose during follow-up significantly predicted the development of hepatic steatosis, even after adjustment for metabolic syndrome components at baseline.ConclusionsThe presence at baseline and the development of metabolic syndrome during follow-up were risk factors for ultrasonographically detected hepatic steatosis.