Prevalence of and risk factors for hepatic steatosis in northern Italy

Citation
S. Bellentani et al., Prevalence of and risk factors for hepatic steatosis in northern Italy, ANN INT MED, 132(2), 2000, pp. 112-117
Citations number
33
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
ANNALS OF INTERNAL MEDICINE
ISSN journal
00034819 → ACNP
Volume
132
Issue
2
Year of publication
2000
Pages
112 - 117
Database
ISI
SICI code
0003-4819(20000118)132:2<112:POARFF>2.0.ZU;2-I
Abstract
Background: Although hepatic steatosis is seen with increasing frequency in clinical practice, its prevalence and risk factors are unknown. Objective: To investigate the prevalence of and risk factors for hepatic st eatosis, such as alcohol consumption and obesity. Design: Cross-sectional, observational study. Setting: Participants in the Dionysos Study. Patients: 257 participants assigned to one of four categories (67 controls, 66 obese persons, 69 heavy drinkers, and 55 obese heavy drinkers). Measurements: Ethanol intake, assessed by a validated questionnaire and exp ressed as daily (g/d) and lifetime (kg) consumption, and body mass, express ed as body mass index. Biochemical tests of liver and metabolic function an d hepatic ultrasonography were done. Results: The prevalence of steatosis was increased in heavy drinkers (46.4% [95% CI, 34% to 59%]) and obese persons (75.8% [CI, 63% to 85%]) compared with controls (16.4% [CI, 8% to 25%]). Steatosis was found in 94.5% (CI, 85 % to 99%) of obese heavy drinkers. Compared with controls, the risk for ste atosis was higher by 2.8-fold (CI, 1.4-fold to 7.1-fold) in heavy drinkers, 4.6-fold (CI, 2.5-fold to 11.0-fold) in obese persons, and 5.8-fold (CI, 3 .2-fold to 12.3-fold) in persons who were obese and drank heavily. In heavy drinkers, obesity increased the risk for steatosis by twofold (CI, 1.5-fol d to 3.0-fold) (P < 0.001), but heavy drinking was associated with only a 1 .3-fold (CI, 1.02-fold to 1.6-fold) increase in risk in obese persons (P = 0.0053). Elevated alanine aminotransferase and triglyceride levels are the most reliable markers of steatosis. Conclusions: Steatosis is frequently encountered in healthy persons and is almost always present in obese persons who drink more than 60 g of alcohol per day. Steatosis is more strongly associated with obesity than with heavy drinking, suggesting a greater role of overweight than alcohol consumption in accumulation of fat in the liver.