Yujiro Kida, MD, PhD; Tetsuji Sato, DMD, PhD
Potential Financial Conflicts of Interest: None disclosed.
Kida Y, Sato T. The Metabolic Syndrome as a Predictor of Nonalcoholic Fatty Liver Disease. Ann Intern Med. 2006;144:379-380. doi: 10.7326/0003-4819-144-5-200603070-00022
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Published: Ann Intern Med. 2006;144(5):379-380.
TO THE EDITOR:
Hamaguchi and colleagues (1) reported that the metabolic syndrome is a strong predictor of NAFLD; however, only a small portion of patients with NAFLD have features of nonalcoholic steatohepatitis (NASH). The authors referred to the roles of adipocytokines, such as leptin and adiponectin; however, serum leptin levels in patients with NASH were not statistically different from those in their matched controls (2). In addition, the investigators observed no correlation between serum leptin levels and hepatic histologic findings (2). In comparison, multivariate analysis revealed that patients with NASH had serum adiponectin levels that were lower than those in controls (3). Furthermore, when compared with simple steatosis, NASH was associated with lower serum adiponectin levels and higher insulin resistance (3). Most patients (77%) with NASH had serum adiponectin levels of less than 10 µg/mL, but only 33% of those with pure steatosis had these findings (3).
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