Risk factors for alcohol-related liver injury in the island population of China: a population-based case-control study

AIM：To investigate the association of alcohol dose, duration of drinking and obesity with abnormal alcohol-related liver injury indicators, the prevalence of alcohol-related liver injury in the island population of China.METHODS：Randomized multistage stratified cluster sampling from the island population of China was used in the population-based case-control study. Then interview, physical examination, laboratory assessments and ultrasonography were done. RESULTS：Daily alcohol intake ≥ 20 g, duration of drinking ≥ 5 years and obesity were closely related to alcohol-related liver injury （P 〈 0.05）. The odds-ratio （OR） （95% CI） was 1.965 （1.122-3.442）, 3.412 （1.789-6.507） and 1.887 （1.261-2.824）, respectively. The prevalence rate of alcohol-related liver injury in ≥ 20 g daily alcohol intake group and 〈 20 g daily alcohol intake group was 37.14% and 12.06%, respectively. The prevalence rate of alcohol-related liver injury in ≥ 5 years drinking group and 〈 5 years drinking group was 34.44% and 8.53%, respectively. No significant dose-response relation was found between daily alcohol intake and abnormal alcohol-related liver injury indicators as well as between duration of drinking and abnormal alcohol-related liver injury indicators. There was no significant difference in the prevalence of alcohol-related liver injury between beer drinking group and yellow rice wine drinking group, hard liquor drinking group, multiple drinking group.CONCLUSION：The risk threshold of daily alcohol intake is 20 g and duration of drinking inducing alcohol-related liver injury 5 years in the island population of China. Liver injury induced by obesity should be concerned.     

Protective effect of alcohol consumption for fatty liver but not metabolic syndrome

AIM:To investigate the effect of alcohol on the metabolic syndrome (MS) and fatty liver in Japanese men and women.METHODS:A cross-sectional study was conducted in a medical health checkup program at a general hospital.This study involved 18 571 Japanese men and women,18-88 years of age,with a mean body mass index of 22.6 kg/m 2.A standardized questionnaire was administered.The total amount of alcohol consumed per week was calculated,and categorized into four grades.Fatty liver was examined by ultrasound modified criteria of the revised National Cholesterol Educa-tion Program Adult Treatment Panel Ⅲ and the new International Diabetes Federation.RESULTS:The prevalence of fatty liver decreased in men and women with light to moderate alcohol consumption,whereas the prevalence of MS was not so changed.The prevalence of fatty liver of any grade in men was lower than that in those with no or minimal alcohol consumption.In women with light to moderate alcohol consumption,prevalence of fatty liver was lower than that in women with no or minimal alcohol consumption.By logistic regression analysis,the odds ratio (OR) for MS in women with light alcohol consumption was decreased to 1.0,but this change was not clear in men.The OR for fatty liver was clearly 1.0 in men with any level of alcohol consumption and in women with light to moderate consumption.CONCLUSION:Light to moderate alcohol consumption has a favorable effect for fatty liver,but not for MS in Japanese men and women.     

Alcohol consumption on pancreatic diseases

Although the association between alcohol and pancreatic diseases has been recognized for a long time,the impact of alcohol consumption on pancreatitis and pancreatic cancer(PC)remains poorly defined.Nowadays there is not consensus about the epidemiology and the beverage type,dose and duration of alcohol consumption causing these diseases.The objective of this study was to review the epidemiology described in the literature for pancreatic diseases as a consequence of alcoholic behavior trying to understand the association between dose,type and frequency of alcohol consumption and risk of pancreatitis and PC.The majority of the studies conclude that high alcohol intake was associated with a higher risk of pancreatitis(around 2.5%-3% between heavy drinkers and 1.3%between non drinkers).About 70%of pancreatitis are due to chronic heavy alcohol consumption.Although this incidence rate differs between countries,it is clear that the risk of developing pancreatitis increases with increasing doses of alcohol and the average of alcohol consumption vary since 80 to 150 g/d for 10-15 years.With regard to PC, the role of alcohol consumption remains less clear,and low to moderate alcohol consumption do not appear to be associated with PC risk,and only chronic heavy drinking increase the risk compared with lightly drinkers.In a population of 10%-15%of heavy drinkers, 2%-5%of all PC cases could be attributed to alcohol consumption.However,as only a minority(less than 10%for pancreatitis and 5%for PC)of heavily drinkers develops these pancreatic diseases,there are other predisposing factors besides alcohol involved.Genetic variability and environmental exposures such as smoking and diet modify the risk and should be considered for further investigations.     

Favorable effect of modest alcohol consumption to fatty liver disease

We previously reported that modest alcohol consumption was significantly inversely associated with fatty liver disease.Feng et al pointed out a discrepancy of statistical significance between our current larger scale cohort and a previous cohort.However,the prevalence of non-alcoholic fatty liver disease was higher in non or minimal drinkers than those in light drinkers in both cohorts.They also argue that some potential co-factors such as soft drink consumption and genetic variations should be discussed.     

Alcohol consumption in relation to the incidence of atrial fibrillation in an elderly Chinese population

BACKGROUND Alcohol consumption is a known modifiable risk factor for atrial fibrillation.The association,however,might differ according to gender.We investigated gender-specific associations between alcohol consumption and incident atrial fibrillation in an elderly Chinese population.METHODS Our study participants were elderly residents(≥65 years)recruited from five community health centers in the urban area of Shanghai(n=6,618).Alcohol intake was classified as never drinkers and current light-to-moderate(<40 g/day)and heavy drinkers(≥40 g/day).Atrial fibrillation was detected by a 30-s single-lead electrocardiography(ECG,AliveCor?Heart Monitor)and further evaluated with a regular 12-lead ECG.RESULTS During a median of 2.1 years(interquartile range:2.0?2.2)follow-up,the incidence rate of atrial fibrillation was 1.10%in all study participants.It was slightly but non-significantly higher in men(n=2849)than women(n=3769,1.30%vs.0.96%,P=0.19)and in current drinkers(n=793)than never drinkers(n=5825,1.64%vs.1.03%,P=0.12).In both unadjusted and adjusted analyses,there was interaction between sex and current alcohol intake in relation to the incidence of atrial fibrillation(P<0.0001).After adjustment for confounding factors,current drinkers had a significantly higher incidence rate of atrial fibrillation than never drinkers in women(12.96%[7/54]vs.0.78%[29/3715],adjusted odds ratio[OR]=10.25,95%confidence interval[CI]:3.54?29.67,P<0.0001),but not in men(0.81%[6/739]vs.1.47%[31/2110],OR=0.62,95%CI:0.25?1.51,P=0.29).CONCLUSIONS Our study showed a significant association between alcohol intake and the incidence of atrial fibrillation in elderly Chinese women,but not men.     

Pediatric nonalcoholic fatty liver disease: overview with emphasis on histology

Nonalcoholic fatty liver disease(NAFLD) is a disease in which excessive fat accumulates in the liver of a patient without a history of alcohol abuse.This disease includes simple steatosis and nonalcoholic steatohepatitis(NASH).NAFLD/NASH is recognized as a hepatic manifestation of metabolic syndrome.In recent years,pediatric NAFLD has increased in line with the increased prevalence of pediatric obesity.The estimated prevalence of pediatric NAFLD is 2.6%-9.6%,and it is associated with sex,age,and ethnicity.W...     

Risk factors for alcoholic liver disease in China

AIM:To examine the association of daily alcohol intake,types of alcoholic beverage consumed,drinking patternsand obesity with alcoholic liver disease in China.METHODS:By random cluster sampling and a 3-yearfollow-up study,1270 alcohol drinkers were recruited fromdifferent occupations in the urban and suburban areas ofXi'an City.They were examined by specialists and inquiredfor information on:Medical history and family medicalhistory,alcohol intake,types of alcoholic beverageconsumed,drinking patterns by detailed dietaryquestionnaires.Routine blood tests and ultrasonographywere done.RESULTS:Multivariate analysis showed that:(1) The riskthreshold for developing alcoholic liver disease wasingestion of more than 20 g alcohol per day,keeping ondrinking for over 5 years in men.The highest OR was atthe daily alcohol consumption≥160g,the occurrencerate of ALD amounted to 18.7% (P<0.01).No ALDoccurred when ingestion of alcohol was less than 20gper day.(2) 87.9% of all drank only at mealtimes.Thecumulative risk of developing ALD was significantly higherin those individuals who regularly drank alcohol withoutfood than in those who drank only at mealtimes,especiallyfor those who regularly drank hard liquors only andmultiple drinks (P<0.05).(3) The alcohol consumption inthose with BMI≥25 was lower than in those with BMI<25,but the risk increased to 11.5%,significantly higherthan that of general population,6.5% (P<0.01).(4)Abstinence and weight reduction could benefit the liverfunction recovery.CONCLUSION:In the Chinese population the ethanol riskthreshold for developing ALD is 20 g per day,and this riskincreases with increased daily intake.Drinking 20g ofethanol per day and for less than 5 years are safe fromALD.Drinking alcohol outside mealtimes and drinking hardliquors only and multiple different alcohol beverages bothincrease the risk of developing ALD.Obesity also increasesthe risk.Abstinence and weight reduction will directly affectthe prognosis of ALD.Doctor's strong advice might influencethe prognosis indirectly.     

Characteristics of and risk factors for colorectal neoplasms in young adults in a screening population

AIM: To investigate prevalence and risk factors for colorectal neoplasms in adults aged 50 years, for whom screening is not recommended.METHODS: This cross-sectional study compared prevalence and characteristics of colorectal and advanced adenomas in patients aged 50 years who underwent colonoscopy screening with subjects aged ≥ 50 years. To evaluate risk factors for colorectal and advanced adenoma in young adults, we used multivariable logistic regression models. Colorectal neoplasm characteristics were evaluated and compared with those in older patients.RESULTS: Among 2819 patients included, prevalences of colorectal adenoma and advanced adenoma were 19.7% and 1.5%, respectively. As patient age increased, so did the prevalence of colorectal neoplasm. However, prevalence of advanced adenoma did not differ between age-groups 45-49 years and ≥ 50 years(OR = 0.43, 95%CI: 0.17-1.07, P = 0.070). In younger age-group( 50 years), colorectal adenoma was significantly associated with older age, waist circumference(OR = 1.72, 95%CI: 1.15-2.55, P = 0.008), and current smoking(OR = 1.60, 95%CI: 1.07-2.41, P = 0.023). Alcohol consumption was an independent risk factor for colorectal advanced adenoma(OR = 3.69, 95%CI: 1.08-12.54, P = 0.037). Multiple neoplasms and large neoplasms(≥ 1 cm) were more prevalent in subjects ≥ 50 years.CONCLUSION: Current screening strategies for colorectal cancer may need to be amended to account for patient age, especially in young subjects with abdominal obesity, current smoking and alcohol consumption.     

Interactions of the LIPG 584C>T polymorphism and alcoholconsumption on serum lipid levels

Both endothelial lipase gene(LIPG)584C>T (rs2000813)polymorphism and alcohol consumption modulate serum lipid levels.But their interactions on serum lipid profiles are not well known.The present study was undertaken to detect the interactions of LIPG 584C>T polymorphism and alcohol consumption on serum lipid levels.Genotyping of the LIPG 584C>T was performed in 763 nondrinkers and 520 drinkers aged 15-85.Interactions between the genotypes and alcohol consumption were assessed by using a cross-product term.The levels of serum total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),apolipoprotein (Apo) AI,and the ratio of ApoAI to ApoB were higher in drinkers than in nondrinkers(P<0.01 for all).There was no significant difference in the genotypic and allelic frequencies between nondrinkers and drinkers.The levels of serum TC, HDL-C and ApoAI in nondrinkers were different among the three genotypes(P<.05-.01).The subjects with CT genotype had higher serum TC,HDL-C and ApoAI levels than the subjects with CC genotype.The levels of serum HDL-C and ApoAI in drinkers were different among the three genotypes (P<.001 and P<.05;respectively).The individuals with TT genotype had higher serum HDL-C and ApoAI levels than the individuals with CC and CT genotypes.The levels of TC in nondrinkers were correlated with LIPG 584C>T allele (P<.05),whereas the levels of TG and HDL-C were associated with LIPG 584C>T alleles(P<.05) and genotypes (P<.05);respectively.The present study suggests that the subjects with TT genotype benefited more from alcohol consumption than the subjects with CT and TT genotypes in increasing serum HDL-C and ApoAI levels.     

Risk factors for alcoholic liver disease in China

AIM: To examine the association of daily alcohol intake,types of alcoholic beverage consumed, drinking patterns and obesity with alcoholic liver disease in China.METHODS: By random cluster sampling and a 3-year follow-up study, 1 270 alcohol drinkers were recruited from different occupations in the urban and suburban areas of Xi‘an City. They were examined by specialists and inquired for information on: Medical history and family medical history, alcohol intake, types of alcoholic beverage consumed, drinking patterns by detailed dietary questionnaires. Routine blood tests and ultrasonography were done.RESULTS: Multivariate analysis showed that: (1) The risk threshold for developing alcoholic liver disease was ingestion of more than 20 g alcohol per day, keeping on drinking for over 5 years in men. The highest OR was at the daily alcohol consumption ≥160 g, the occurrencerate of ALD amounted to 18.7% (P&lt;0.01). No ALD occurred when ingestion of alcohol was less than 20 g per day. (2) 87.9% of all drank only at mealtimes. The cumulative risk of developing ALD was significantly higher in those individuals who regularly drank alcohol without food than in those who drank only at mealtimes, especially for those who regularly drank hard liquors only and multiple drinks (P&lt;0.05). (3) The alcohol consumption in those with BMI ≥25 was lower than in those with BMI&lt;25, but the risk increased to 11.5%, significantly higher than that of general population, 6.5% (P&lt;0.01). (4) Abstinence and weight reduction could benefit the liver function recovery.CONCLUSION: In the Chinese population the ethanol risk threshold for developing ALD is 20 g per day, and this risk increases with increased daily intake. Drinking 20 g of ethanol per day and for less than 5 years are safe from ALD. Drinking alcohol outside mealtimes and drinking hard liquors only and multiple different alcohol beverages both increase the risk of developing ALD. Obesity also increases the risk, Abstinence and weight reduction will directly affect the prognosis of ALD, Doctor‘s strong advice might influence the prognosis indirectly.     

Association between alcohol intake and metabolic syndrome in patients with hypertension

The aim of this study was to determine how alcohol consumption influences metabolic syndrome in patients with hypertension. The subjects were 3938 male workers being treated with anti-hypertensive drugs and they were divided into four groups by average ethanol intake [non-, light (<22 g/day), moderate (≥22 and <44 g/day), and heavy (≥44 g/day) drinkers]. The relationships of alcohol intake with atherosclerotic risk factors and metabolic syndrome were investigated. Waist circumference and hemoglobin A1c were significantly smaller and lower, respectively, in light, moderate, and heavy drinkers than in nondrinkers. Systolic blood pressure and log-converted triglyceride were significantly higher in heavy drinkers than in nondrinkers. HDL cholesterol was significantly higher in all of the drinker groups than in nondrinkers and tended to be higher as alcohol intake increased. Prevalence of metabolic syndrome was significantly lower in light, moderate, and heavy drinkers than in nondrinkers. Age- and smoking history-adjusted odds ratios (ORs) vs. nondrinkers for metabolic syndrome were significantly low in light drinkers (OR = 0.71, 95% confidence interval [CI]: 0.56-0.89), moderate drinkers (OR = 0.64, 95% CI: 0.54-0.75) and heavy drinkers (OR = 0.68, 95% CI: 0.57-0.82). The results suggest that alcohol drinking is associated with a lower risk of metabolic syndrome in patients with hypertension.     

Alcohol intake and dyslipidemia in male patients with hypertension and diabetes enrolled in a China multicenter registry

Alcohol consumption is a proven risk factor of dyslipidemia. In the present analysis, we investigated the association of alcohol intake with dyslipidemia, an emerging epidemic in China, in male patients with hypertension and diabetes mellitus. Our study participants were from a nationwide registry (n = 1181). A questionnaire was administered to collect information on alcohol intake. Dyslipidemia was defined as an elevated concentration of serum triglycerides (≥2.3 mmol/L), total (≥6.2 mmol/L) or low-density lipoprotein (LDL) cholesterol (≥4.1 mmol/L), or a reduced high-density lipoprotein (HDL) cholesterol (< 1.0 mmol/L). Serum concentrations of triglycerides (1.60 mmol/L) and total (4.93 mmol/L) and LDL cholesterol (2.95 mmol/L) were highest with current usual drinking, with a significant P value for trend from never (n = 679) to ever (n = 107) and to rare (n = 187) and usual drinkers (n = 208, P ≤ .002). Serum HDL cholesterol (1.13 mmol/L) was lowest in ever drinkers, with a nonsignificant P value for trend (P = .22). The prevalence was highest in usual drinkers for hypertriglyceridemia (27.4%) and total (12.5%) and LDL hypercholesterolemia (8.7%), and in ever drinkers for low HDL cholesterol (34.6%). The P value for trend was significant for hypertriglyceridemia and total hypercholesterolemia (P ≤ .01), but not for LDL hypercholesterolemia or low HDL cholesterol (P ≥ .26). The between-province ecological analysis showed that the proportion of usual drinking was significantly associated with the prevalence of any dyslipidemia across 10 China provinces (r = .42, P < .0001). In conclusion, alcohol drinkers showed a worse lipid profile in patients with hypertension and diabetes mellitus. Usual drinking ecologically explained the between-province variation in the prevalence of dyslipidemia.     

Synergistic effect of alcohol consumption and body mass on serum concentrations of cytokeratin-18

Background: Cytokeratin‐18 is an essential component of the cytoskeleton of epithelial cells (including hepatocytes). Serum concentrations of cytokeratin‐18 (tissue polypeptide‐specific antigen [TPS]) are used as a marker of epithelial neoplasms. Here, we investigated the potential interaction between alcohol and obesity in relation to serum TPS concentrations. Methods: Alcohol consumption, body mass index, and components of metabolic syndrome were measured in a random sample (n = 420) of the adult population (aged 18 to 92 years, 45% men) from a single municipality. Regular alcohol intake of >20 g/d (women) or >30 g/d (men) was considered risky drinking. Serum TPS was measured with a commercial immunoassay. Results: Risky drinking was associated with increased serum concentrations of TPS, which was particularly evident among obese individuals. Among individuals without risky drinking, TPS concentrations were similar for all levels of body mass. Conversely, among risky drinkers, serum TPS concentrations increased in parallel with body mass (p = 0.002). The odds ratio of a high (>100 U/l) TPS concentration for the combination of risky drinking and obesity was greater than the additive effect of the 2 separate factors, after adjusting for age and sex. A similar interaction was observed between risky drinking and abdominal adiposity, a major component of the metabolic syndrome. Serum TPS concentrations were correlated with markers of liver damage. Serum TPS was not superior to standard markers (gamma‐glutamyl transferase and red blood cell mean volume) for the detection of risky drinking. Conclusions: There is a synergism between risky alcohol consumption and common metabolic disorders (particularly obesity) in relation to serum concentrations of cytokeratin‐18 (TPS), which probably reflect liver disease.     

The metabolic syndrome: prevalence and risk factors in the urban population of Ho Chi Minh City

The purpose of this study was to determine the prevalence of metabolic syndrome (MeS) and its risk factors in urban population of Ho Chi Minh City. A cross-sectional study was conducted in urban areas of Ho Chi Minh City with 611 participants. The demographic, socio-economic details, anthropometric indexes and blood pressure were recorded. A fasting blood sample was collected for the analyses of glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). MeS was defined by presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-cholesterolemia, high blood pressure and high fasting plasma glucose. The crude prevalence of MeS was 18.5% (95% CI: 15.5-21.9). After age, sex standardization, this prevalence was 12.0% (95% CI: 10.9-13.2). The prevalence increased with age and sedentary work. Subjects with MeS had significantly higher body fat percentage than that of normal subjects. Metabolic syndrome showed a positive association with age, body fat percentage and sedentary occupation. This first study on MeS showed that 12% adults in urban areas of Ho Chi Minh City had metabolic syndrome. It suggests that MeS is becoming a noteworthy health problem in Vietnam and to the early detection and appropriate intervention as well as healthy lifestyle education programs need to be established.     

Association of lifetime alcohol drinking trajectories with cardiometabolic risk

CONTEXT AND OBJECTIVE: Alcohol intakes may vary considerably over a drinker's lifetime. This study was designed to examine whether lifetime drinking trajectories are associated with cardiovascular risk factors that are used to define the metabolic syndrome (MetS). DESIGN, SETTING, PARTICIPANTS, AND OUTCOMES: This is a population-based cross-sectional study. Participants were ever-regular drinkers (n = 2818) selected from healthy controls for the Western New York Health Study (1996-2001) in which lifetime lifestyle was ascertained retrospectively. Prevalence of the MetS and its individual components, including obesity, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure, and high fasting glucose, were the main outcomes. RESULTS: Trajectory analyses were based on estimates of total kilograms of ethanol for each age decade between 10 and 59 yr. Two groups of drinkers with distinct lifetime drinking trajectories were obtained, an early peak and a stable trajectory group. Compared with stable trajectory drinkers, early-peak drinkers were 10 yr younger on average, had earlier onset of regular drinking, drank heavily in late adolescence and early adulthood tapering off in middle age, averaged more drinks per drinking day in lifetime, and were more likely to abstain when interviewed. After controlling for age, sex, and other potential confounders, early-peak trajectories were modestly associated with high odds of the MetS [1.31; 95% confidence interval (CI) 1.00, 1.71] overall, low high-density lipoprotein cholesterol (1.62; 95% CI 1.27, 2.08), abdominal obesity (1.48; 95% CI 1.23, 1.78), and overweight (1.32; 95% CI 1.10, 1.60). CONCLUSION: Early initiation of alcohol drinking and heavy drinking in adolescence and early adulthood may be associated with an adverse cardiometabolic profile.     

Association of drinking pattern and alcohol beverage type with the prevalence of metabolic syndrome, diabetes, coronary heart disease, stroke, and peripheral arterial disease in a Mediterranean cohort

The purpose of this study was to investigate the relationship between alcohol consumption and the prevalence of the metabolic syndrome (MetS), type 2 diabetes mellitus (DM), coronary heart disease (CHD), stroke, peripheral arterial disease (PAD), and overall cardiovascular disease (CVD) in a Mediterranean cohort. It consisted of a cross-sectional analysis of a representative sample of Greek adults (n = 4,153) classified as never, occasional, mild, moderate, or heavy drinkers. Cases with overt CHD, stroke, or PAD were recorded. In our population, 17% were never, 23% occasional, 27% mild, 24% moderate, and 9% heavy drinkers. Moderate alcohol consumption was associated with a lower trend for the prevalence of the MetS (P = .0001), DM (P < .0001), CHD (P = .0002), PAD (P = .005), and overall CVD (P = .001) but not stroke compared with no alcohol use. Heavy drinking was associated with an increase in the prevalence of all of these disease states. Wine consumption was associated with a slightly better effect than beer or spirits consumption on the prevalence of total CVD, and beer consumption was associated with a better effect than spirits consumption. Alcohol intake was positively related with body weight, high-density lipoprotein cholesterol levels, and hypertension. Moderate alcohol consumption is associated with a lower prevalence of the MetS, DM, PAD, CHD, and overall CVD but not stroke compared with no alcohol use in a Mediterranean population. Heavy drinking was associated with an increase in the prevalence of all of these disease states. Advice on alcohol consumption should probably mainly aim at reducing heavy drinking.     

上海市成人脂肪肝患病率及其危险因素流行病学调查

目的 明确上海市成人脂肪肝的患病率及其主要危险因素。 方法 通过随机多级分层整群抽样对杨浦区和浦东新区各4个居委会16岁以上居民进行调查,内容涉及问卷咨询、体格检查、75 g葡萄糖耐量试验、血脂检测、以及肝脏实时超声检查。 结果 3175名成人完成调查,约占上海市人口的2.26／10000。其中男性1218名,女性1957名,平均年龄(52.4±15.1)岁。B超共检出脂肪肝661例,占20.82％,其中酒精性、可疑酒精性、非酒精性脂肪肝分别占3.48％、4.08％及92.43％。经年龄和性别调整后,上海市成人脂肪肝患病率为17.29％,酒精性脂肪肝、可疑酒精性脂肪肝、非酒精性脂肪肝患病率分别为0.79％、1.15％、15.35％。无论是男性还是女性,脂肪肝患病率均随年龄增长而增加,50岁之前男性脂肪肝患病率显著高于女性(x2=13.934,P<0.01),而50岁以后女性脂肪肝患病率显著高于男性(x2=4.146,P<0.05)。脂肪肝组年龄、体重指数(BMI)、腰围、血压、空腹及餐后血糖、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肥胖、糖尿病、高血压病、血脂异常和胆石症患病率等均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)水平以及文化程度显著低于对照组。多元回归分析显示:男性、文化程度、腰围、BMI、HDL-C、TG、空腹血糖水平、糖尿病、     

Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study

The aim of the present investigation was to determine the prevalence of the metabolic syndrome among 103,68 of the adults (4,397 men and 5,971 women) aged 20 years and over, participating in the Tehran Lipid and Glucose Study. The metabolic syndrome was defined by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose. The unadjusted prevalence of metabolic syndrome in the study population was 30.1% (CI 95%: 29.2-31.0) and age-standardized prevalence was 33.7% (CI 95%: 32.8-34.6). The prevalence increased with age in both sexes. The metabolic syndrome was more commonly seen in women than in men (42% vs. 24%, P<0.001). Low HDL-C was the most common metabolic abnormality in both sexes. Except for high FPG, all abnormalities were more common in women than in men (P<0.001). Most of those with metabolic syndrome had three components of the syndrome (58%), 33% had four, and 9% had five components. This report on the metabolic syndrome from Iran shows a high prevalence of this disorder. Efforts on promoting healthy diets, physical activity, and blood pressure control must be undertaken.     

Effect of ethanol on metabolic syndrome

Metabolic syndrome is characterized by a group of risk factors for cardiovascular diseases, such as abdominal obesity, low high-density lipoprotein (HDL) cholesterol, elevated triglycerides, elevated arterial blood pressure, insulin resistance or impaired glucose tolerance. A number of studies focused on the relationship between alcohol consumption and prevalence of metabolic syndrome and its individual components. Ethanol can either aggravate the syndrome or prevent it--this depends primarily on the amounts and types of alcohol beverages consumed. It is commonly believed that moderate alcohol consumption is associated with a decreased incidence of metabolic syndrome and beneficial effects on plasma lipid levels, waist circumference and fasting plasma glucose. Of all the components of metabolic syndrome, the most beneficial effect of ethanol arises from an increase in plasma HDL cholesterol levels. The relationship between alcohol consumption and incidence of metabolic syndrome is more pronounced among red wine drinkers because polyphenoles contained in red wine increase the activity of endothelial nitric oxide synthase (eNOS), which plays a key role in the pathogenesis of metabolic syndrome. Decreased activity of this enzyme contributes to the development of insulin resistance, arterial hypertension and dyslipidemia. Stimulation of eNOS activity, which participates in the transport of HDL molecules, may provide an explanation for the mechanism of the increase in plasma levels of this particular lipid fraction in response to ethanol. Endothelial nitric oxide synthase requires the presence of antioxidants, which prevent both inactivation of nitric oxide in the reaction with peroxide anions and the accumulation of peroxynitrates.     

Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study

Objective In order to estimate the prevalence of metabolic syndrome (MetS) as defined by NCEP Adult Treatment Panel III (ATP III) criteria in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption) in the adult population. Research Methods and Procedures In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4,809 adult subjects ≥20 years (2,601 women and 2,208 men) were included in the study. Blood pressure levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00 and 10:00 following 12 h of fasting. Fasting serum glucose (FBG) levels and lipid profile were measured with autoanalyzer. MetS was defined according to guidelines from the NCEP ATP III diagnostic criteria. Results The prevalence of MetS was 26.9%: 31.3 in women and 21.7% in men. The prevalence increased with age, being highest in the 60–69-year-old age group (53.4%) but lower again in the ≥70 age group. MetS was associated positively with marital status, parity, cessation of cigarette smoking, and negatively with the level of education, alcohol consumption, current cigarette use, household income, and physical activity. Hypertension was found as the most common MetS component in our study (57.4%). Others in decreasing order were abdominal obesity (40.9%), low high-density lipoprotein-C (HDL-C) (31.8%), hypertriglyceridemia (30.7%), and high FBG levels (9.2%). Similarly, in the subjects diagnosed with MetS, HT had the highest prevalence (91.9%). This was followed by abdominal obesity (82.3%), hypertriglyceridemia (74%), low HDL-C (68.6%), and high fasting blood glucose levels (28.6%). Discussion MetS is moderately common and an important health problem in the adult population of Trabzon. In order to control MetS and its components, effective public health education and taking urgent steps are needed. These steps include serious education, providing a well-balanced diet and increasing physical activity.