Fatty infiltration of liver in hyperlipidemic patients

Hyperlipidemia is a known risk factor for fatty infiltration of the liver, a condition that can progress to cirrhosis and liver failure. The objective s of this study were to document the prevalence of fatty infiltration in th e livers of hyperlipidemic patients and to identify the predictor variables associated with this condition. Over an 18-month recruitment period, clini cal, biochemical, and radiologic assessments were performed in a cross-sect ional manner in 95 adult patients referred to an urban hospital-based lipid clinic for evaluation and management of hyperlipidemia. The mean (+/-SD) a ge of the patients was 55 +/- 13 years. Forty-eight (51%) were male. Fifty- two patients (55%) had hypercholesterolemia, 25 (26%) severe hypertriglycer idemia, 14 (15%) mixed hyperlipidemia, and 4 (4%) moderate hypertriglycerid emia. Obesity and diabetes were present in 36 (38%) and 12 (12%) of cases, respectively. A total of 61 (64%) patients had elevated liver enzyme tests. The most common enzyme abnormalities were an elevated serum ALT in 45 (47% ) and GGT in 43 (45%) of patients. Ultrasound findings revealed diffuse fat ty liver in 47 patients (50%), of which 21 cases (22%) were mild, 18 (19%) moderate, and 8 (9%) severe. The majority of patients with hypercholesterol emia [35/52 (67%)] had normal ultrasounds, whereas severe hypertriglyceride mia and mixed hyperlipidemia were frequently associated with radiologic evi dence of fatty liver (odds ratios 5.9 and 5.1 respectively, P < 0.01). Inde pendent predictors of fatty liver were; AST (P = 0.001), hyperglycemia (P = 0.02), and age (P = 0.04). In a model incorporating known risk factors for fatty liver, diabetes was the only risk factor other than hypertriglycerid emia that was significantly associated with fatty infiltration. No such eff ect was seen with age, gender, obesity, or alcohol consumption. In conclusi ons, the results of this study indicate that ultrasonographic evidence of f atty infiltration of the liver is evident in approximately 50% of patients with hyperlipidemia. Hypertriglyceridemia is the lipid profile most often a ssociated with this condition. Serum AST values, hyperglycemia, and age ind ependently predict the presence of fatty infiltration, while hypertriglycer idemia and diabetes are the only risk factors that significantly increase t he risk of fatty infiltration in hyperlipidemic patients.