高血压患者体重指数与脂肪肝相关性探讨

目的　探讨高血压患者体重指数与脂肪肝、血脂及血压之间的关系。方法　对 13 5例高血压患者按体重指数(BMI)分为 3组 :正常体重组 (BMI=2 0～ 2 3 ) ,超重组 (BMI=2 4～ 2 7) ,肥胖组 (BMI≥ 2 8) ,所有患者均测血脂、血压 ,并行腹部 B超检查。结果　肥胖组较正常组总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白 (L DL )有明显差异(P<0 .0 5 ) ;肥胖组与超重组比较 ,仅 TC有差异 (P<0 .0 5 )。 BMI与脂肪肝的发生率呈正相关 (rs=0 .911,P<0 .0 1) ,且肥胖组中中、重度脂肪肝的发生率较正常组明显增多 (P<0 .0 1)。收缩压 (SBP)及舒张压 (DBP)均随着BMI的增加而明显增高 :肥胖组高于超重组 ,超重组高于正常组 ,差异有显著性 (P<0 .0 0 1及 P<0 .0 5 )。结论　合并超重的高血压患者应积极减重 ,并控制在正常范围 ,对降低血压、预防冠心病及脂肪肝均有重要意义     

糖尿病合并高血压体检人群体重指数与血脂、脂肪肝的关联性分析及健康生活方式指导

目的探讨糖尿病合并高血压体检人群体重指数(BMI)与血脂、脂肪肝的关联性分析及健康生活方式指导。方法回顾性分析2019年1月—2021年1月在该单位参加健康体检的人群,选取70例糖尿病合并高血压的体检人群,根据BMI分为正常组(15例)、超重组(32例)、肥胖组(23例),分析糖尿病合并高血压体检人群BMI与血脂、脂肪肝的关联性。结果肥胖组的TC、TG、LDL-C明显高于超重组与正常组,肥胖组的HDL-C明显低于超重组与正常组,3组比较差异有统计学意义(P0.05)。肥胖组的血压、空腹血糖及餐后2 h血糖明显高于超重组和正常组,3组比较差异有统计学意义(P0.05)。在对3组糖尿病合并高血压体检人群空腹B超的分析中发现,正常组有5例脂肪肝的患者,占33.33%,超重组有19例脂肪肝患者,占59.38%,肥胖组有18例脂肪肝患者,占78.26%,3组比较差异有统计学意义(χ2=7.645,P=0.022)。BMI指数与TC、TG、LDL-C、脂肪肝呈正相关(r=0.222、0.335、0.344、0.439,95%CI=0.027、0.148、0.159、0.265,P0.05),BMI指数与HDL-C呈负相关(r=-0.690,95%CI=-0.784,P0.05)。结论糖尿病合并高血压体检人群体BMI越高,血脂的水平越高,脂肪肝的发病率越高,对于糖尿病合并高血压的患者要控制饮食,减轻体质量,对控制血糖、血脂和脂肪肝的发展与发生有重大意义。     

甘肃省裕固族地区中老年居民血脂水平的流行病学调查

目的 观察甘肃省裕固族地区中老年居民血脂水平及血脂异常状况,为该地区血脂异常的防治工作提供科学依据.方法 采用整群随机抽样方法,对长期居住在甘肃肃南裕固族自治县的511名中老年居民进行现况调查,检测血浆TC、TG、LDL-C、HDL-C水平.结果 ①高TC、高TG、高LDL-C血症为该地区人群血脂异常的主要类型,异常发生率分别为42.86%、60.86%、53.62%.②血脂异常与年龄、性别有关.60岁以上女性TC及LDL-C显著高于男性(P＜0.05).③裕固族中老年TC、LDL-C水平高于汉族,有显著性差异(P＜0.05).④高血压组TC、LDL-C水平与血压正常组有显著性差异(P＜0.01,P＜0.05),超重肥胖组TC、TG、LDL-C水平均高于正常体重组(P＜0.05).结论 该地区中老年居民为血脂异常的高发人群,血脂异常与超重肥胖、腹型肥胖、高血压具有显著相关性.     

肥胖、高脂血症与急性胰腺炎相关性研究

目的探讨肥胖、高脂血症在急性胰腺炎发病中的影响与作用.方法选择重症急性胰腺炎(SAP)患者98例,轻症急性胰腺炎(MAP)患者107例,测定体重指数(BMI)、血脂水平以及急性胰腺炎相关的实验室检查指标.结果肥胖组(BMI≥28 kg/m2)共有64例,超重组(24≤BMI＜28 kg/m2)和体重正常组(BMI＜24kg/m2)分别有66例和75例.肥胖组SAP比例高于超重组和体重正常组;SAP患者BMI和血三酰甘油高于超重组和体重正常组;对于肥胖的急性胰腺炎患者,血脂升高伴随着更为严重的胰腺和肝肾功能损害,在超重组和体重正常组未观察到同样的效应.结论肥胖影响急性胰腺炎的严重程度,并且肥胖者发生急性胰腺炎后,血脂水平可作为急性胰腺炎严重程度的预测指标.     

40岁以上在职人群体质量指数与动脉粥样硬化的相关性研究

目的:通过探讨40岁以上在职人群BMI与动脉粥样硬化(AS)的相关性,为人群AS防治提供科学依据。方法:对参加北京市某三甲医院2018年健康体检,年龄在40岁以上在职人员571例的体检结果进行统计。按我国卫生部在《中国成人超重和肥胖症预防控制指南》中公布的诊断标准,将该人群分为:偏瘦体质量组(6例)、正常体质量组(271例)、超重组(201例)和肥胖组(93例),因偏瘦一组例数较少,所以本次不做研究。比较三组的血压、血脂浓度、血糖浓度和AS指数情况,以及高血压、血脂异常、高血糖和AS发病情况,并分析这些因素与AS之间的关系。结果:收缩压、舒张压、TG、TC、LDL-C、空腹血糖浓度和AS指数均与BMI呈正相关,而HDL-C则相反;高收缩压、高舒张压、高TG血症、高TC血症、高LDL-C症、低HDL-C血症、高空腹血糖和AS发病率均随BMI增长而增高,超重组和肥胖组AS发病率分别为21.9%和48.4%,与正常体质量组的7.7%比较显著增高(P0.01);单危险因素Logistic回归分析显示:男性、年龄增加、超重、肥胖、高收缩压、高舒张压、高TG血症、高TC血症、高LDL-C症、低HDL-C血症、高空腹血糖均为AS危险因素(P0.01);多危险因素Logistic回归分析结果:与AS有关的危险因素有年龄增长、超重、肥胖、高收缩压、高空腹血糖,其中可控危险因素有肥胖、超重、高收缩压和高空腹血糖,特别是肥胖(OR=10.06,95%CI:4.39～23.03,P0.01)和超重(OR=2.76,95%CI:1.40～5.45,P0.01)危险性较大。结论:40以上的在职群体的BMI是其AS发病的相关因素,BMI越高患AS风险越大。由于此人群中超重和肥胖人数占比超过50%,应高度重视。     

新疆哈族人群体质指数及血脂水平与β2-AR基因+491C/T多态性的关系

目的研究新疆哈萨克族人群体质指数(BMI)、血脂水平与β2-肾上腺素能受体 491C/T多态性的关系.方法以人群为基础的病例-对照研究,针对528例30～60岁哈萨克族人,测量其身高、体重,在此基础上计算BMI,按照WHO的标准将其划分为正常(18.5≤BMI＜25)、超重(25≤BMI＜30)及肥胖(BMI≥30)3组,并采集其血液标本,测定TC、TG、HDL-C,计算LDL-C值,同时采用饱和酚/氯仿法提取外周血白细胞基因组DNA,应用PCR-RFLP技术检测β2-肾上腺素能受体 491C/T基因型及等位基因频率;采用方差分析、t检验、Fisher's精确概率检验、Logistic回归等统计学分析方法,观察不同BMI人群血脂水平的变化、不同基因型人群BMI和血脂水平差异、β2-肾上腺素能受体 491C/T基因型及等位基因频率的分布和TG、TC、BMI与β2-AR基因 491C/T多态性的关系.结果正常、超重、肥胖3组间血清TC、TG的水平随BMI增加而增高(均P＜0.01).正常组β2-肾上腺素能受体 491C/T基因型频率分别是CC 98.91%、CT 1.09%,超重加肥胖组为CC 98.8%、CT 1.2%;正常组等位基因频率分别为C 99.45%、T 0.55%,超重加肥胖组C 99.4%、T 0.60%,分布的差异均无统计学意义.各基因型间BMI、TC、TG差异无统计学意义.结论β2-AR基因 491位点C/T多态性可能不是新疆哈萨克族人群BMI、TG、TC异常的易感因素,而TC、TG水平增高是该人群超重、肥胖的危险因素.     

北京农村老年人体重指数与血压、血糖、血脂关系分析

目的 了解北京大兴农村地区老年超重和肥胖与血压、血糖、血脂等的关系及临床意义.方法 对长子营地区3036名60岁以上老年人(包括超重1328人、肥胖747人、正常体重961人)通过问卷调查获得高血压、糖尿病和吸烟等情况,通过体格检查和实验室检查获得体重指数、血压、血糖、血脂、血尿酸等数据.结果 60岁以上老年女性超重和肥胖者明显多于男性.正常体重组、超重组和肥胖组血压、空腹血糖、TG、LDL-C、尿酸水平依次升高,而HDL-C水平逐渐降低,三组之间差异有统计学意义(P＜0.01).超重和肥胖组的高血压、糖尿病、血脂异常和高尿酸血症发病率明显高于正常体重组.结论 超重和肥胖与高血压、糖尿病、血脂异常和高尿酸血症密切相关,可能是导致老年心脑血管疾病的共同危险因素.     

唐山市体检人群脂肪肝患病率调查分析

目的探究唐山市体检人群脂肪肝患病率情况,以期为脂肪肝的预防和调治提供合理依据。方法采集2014年3月-2016年2月唐山市12 808例体检人群资料,其中脂肪肝有3540例。统计年龄、性别、BMI、空腹血糖(FBG)、TC、TG、LDL-C以及肝脏超声检查结果。计数资料组间比较采用χ2检验;计量资料组间比较采用t检验。结果 7151例男性体检者中脂肪肝2750例(38.46%),5657例女性体检者中脂肪肝790例(13.96%),男性与女性患病率比较差异有统计学意义(χ2=947.25,P0.01)。不同年龄段(18~29岁、30~39岁、40~49岁、≥50岁)男女间脂肪肝检出率比较差异均有统计学意义(χ2值分别为337.58、474.06、449.38、12.86,P值均0.01)。男性、女性在不同BMI[肥胖(BMI≥28)、超重(24≤BMI28)、正常(BMI24))]间脂肪肝的检出率比较差异有统计学意义(χ2值分别为1104.01、500.23,P值均0.01)。分别对肥胖(BMI≥28)、超重(24≤BMI28)、正常(BMI24)体检者中男性与女性脂肪肝检出率进行比较,差异均有统计学意义(χ2分别为71.24、87.97、323.84,P值均0.01)。男性、女性体检者中肥胖及超重人群脂肪肝检出率均显著高于正常人群(P值均0.01)。脂肪肝组与非脂肪肝组FPG、TC、TG、LDL-C比较,差异均有统计学意义(t值分别为17.482、13.698、22.133、27.334,P值均0.001)。男性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为11.288、8.652、11.671、20.118,P值均0.01);女性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为16.816、5.532、15.154、18.507,P值均0.01)。结论唐山市成人体检人群脂肪肝患病率为男性明显高于女性。导致脂肪肝的主要因素可能是超重或肥胖、高脂血症、糖代谢异常。     

载脂蛋白C3基因rs5128多态性与不同体质指数冠心病患者血脂水平及冠状动脉狭窄程度的相关性

目的探讨中国汉族人群载脂蛋白C3(ApoC3)基因rs5128多态性与不同体质指数(BMI)冠心病(CHD)患者血脂水平及冠状动脉狭窄程度的相关性。方法根据BMI将312例CHD患者分为正常体重组(205例)和超重/肥胖组(107例)。收集所有患者的生理生化资料和冠状动脉造影数据,采用Gensini评分法评价CHD患者的冠状动脉狭窄程度。提取外周血白细胞DNA并应用聚合酶链反应-限制性片段长度多态性法对ApoC3rs5128多态性分型。结果超重/肥胖组体重、BMI、高血压患病率、甘油三酯(TG)、脂蛋白a、TG/高密度脂蛋白胆固醇(HDLC)、总胆固醇(TC)/HDLC、低密度脂蛋白胆固醇(LDLC)/HDLC和载脂蛋白B100(ApoB100)/载脂蛋白AI(ApoAⅠ)水平高于正常体重组,HDLC和ApoAⅠ水平低于正常体重组(P0.05)。在正常体重组中,G等位基因携带者高血压患病率显著高于CC基因型患者(P0.05);在超重/肥胖组中,G等位基因携带者TG和TG/HDLC水平显著高于CC基因型患者(P0.05)。在正常体重组和超重/肥胖组中,rs5128多态性基因型和等位基因频率在不同冠状动脉狭窄程度亚组中的分布差异无统计学意义(P0.05)。结论在超重/肥胖CHD患者中,rs5128多态性G等位基因与血浆TG和TG/HDLC水平升高显著相关,但与冠状动脉狭窄程度无明显关联。     

脂肪肝与血脂的相关性分析

目的探讨脂肪肝与高脂血症的发病率,以及二者之间的关系。方法2007年在我院健康体检的郑州市企事业单位1016例干部职工,经B超诊断脂肪肝,并做血清总胆固醇（TC）、甘油三酯（TG）检测,观察脂肪肝及高脂血症发病率,脂肪肝与年龄、性别、血脂的关系。结果脂肪肝患病率68．11％,高脂血症者患病率60．83％,明显高于正常者。中老年及男性脂肪肝的患病率明显增高。脂肪肝患者的血清胆固醇、甘油三酯均明显增高。结论脂肪肝的发生与年龄、性别、血脂有密切关系。     

脂肪肝或丙氨酸氨基转移酶升高的患者中代谢异常的患病情况比较

目的 比较脂肪肝或丙氨酸氨基转移酶异常的患者中代谢异常的患病情况,探讨两者对代谢的影响.方法 以上海宝钢集团股份公司2001年1月～2002年12月参加体检的职工为研究对象,应用SPSS 11.5软件进行统计处理.结果 在该研究人群中,脂肪肝的患病率为14.08%,其中非酒精性脂肪性肝病（NAFLD）的患病率为11.16%;转氨酶异常的患病率为3.17%,脂肪肝患者中转氨酶异常的患病率为11.7%,转氨酶异常的患者中脂肪肝患病率为51.9%.根据是否患有脂肪肝和转氨酶异常,将研究人群分组后,发现在转氨酶异常的两组间（伴有和不伴有脂肪肝）,性别、年龄、体重指数（BMI）、收缩压、舒张压以及肥胖的患病率无差异,但伴有脂肪肝组的血脂、血糖、血红蛋白的水平以及高血压、高脂血症和空腹血糖异常（IFG）及糖尿病的患病率明显高于无脂肪肝组（P＜0.01）;而在患有脂肪肝两组间（伴有和不伴有转氨酶异常）,转氨酶异常组的年龄、BMI、血压和血红蛋白的水平以及肥胖和高血压的患病率高于转氨酶正常组（P＜0.01）,而血脂、血糖的水平及高脂血症、IFG、糖尿病的患病率两组间无差异.结论 单纯脂肪肝对血脂、血糖的影响要大于其对BMI、血压的影响.脂肪肝患者出现转氨酶异常,可能不仅仅是肝脏损伤的表现,还可能是年龄增长、肥胖和高血压加重的表现.     

减体重对肥胖和超重者心血管病危险因素的影响

目的：探讨对肥胖和超重者的减肥对心血管危险因素的影响。方法：对41名肥胖和超重者采取6周封闭管理的集中减肥，控制饮食，进行运动训练，每2周测定体重、腰臀围等指标，减肥前、后进行空腹血脂、血糖、血胰岛素、血转氨酶及肝脏超声检查。结果：通过6周减肥，受试者的体重、体重指数、腰围、臀围、腰臀围比、皮褶厚度、体脂含量及百分比、静息血压、心率呈非常明显的下降（P〈0．001）：减肥后血丙氨酸氨基转移酶、甘油三酯、胰岛素及胰岛素抵抗指数明显下降（P〈0．05-〈0．001），血高密度脂蛋白-胆固醇明显升高（P〈0．001），脂肪肝显著改善（P=0．001）。结论：运动锻炼结合饮食控制可减轻肥胖和超重者的体重，有效降低心血管疾病的危险因素。     

1372例社区老年人群超重及肥胖的现况调查

目的 了解顺德地区老年人群超重及肥胖的现况.方法 在佛山市顺德区容桂街道整群随机抽取2个村中年龄≥60岁的常住人口调查,总人数1503例,最终入选资料完整的1372例,男性570例,女性802例,60～69岁857例,70～79岁416例,≥80岁99例.调查入选者年龄、性别、身高、体重、腰围、臀围、空腹血糖(FPG)...     

The epidemiology of obesity

In the United States, obesity among adults and overweight among children and adolescents have increased markedly since 1980. Among adults, obesity is defined as a body mass index of 30 or greater. Among children and adolescents, overweight is defined as a body mass index for age at or above the 95th percentile of a specified reference population. In 2003-2004, 32.9% of adults 20-74 years old were obese and more than 17% of teenagers (age, 12-19 y) were overweight. Obesity varies by age and sex, and by race-ethnic group among adult women. A higher body weight is associated with an increased incidence of a number of conditions, including diabetes mellitus, cardiovascular disease, and nonalcoholic fatty liver disease, and with an increased risk of disability. Obesity is associated with a modestly increased risk of all-cause mortality. However, the net effect of overweight and obesity on morbidity and mortality is difficult to quantify. It is likely that a gene-environment interaction, in which genetically susceptible individuals respond to an environment with increased availability of palatable energy-dense foods and reduced opportunities for energy expenditure, contributes to the current high prevalence of obesity. Evidence suggests that even without reaching an ideal weight, a moderate amount of weight loss can be beneficial in terms of reducing levels of some risk factors, such as blood pressure. Many studies of dietary and behavioral treatments, however, have shown that maintenance of weight loss is difficult. The social and economic costs of obesity and of attempts to prevent or to treat obesity are high.     

Prevalence of obesity and associated complications in China: A cross-sectional,real-world study in 15.8 million adults

Aim

To evaluate the prevalence of overweight/obesity and associated complications from a large, cross-sectional, nationwide database in China.

Materials and Methods

Data were obtained from 519 Meinian health check-up centres across 243 cities. Eligible participants were aged ≥18 years, with a routine check-up in 2019 (N = 21 771 683) and complete height, weight, sex and region data. The unadjusted prevalence rates of overweight/obesity were calculated by age, sex and region. In addition, the nationwide prevalence rates of overweight and obesity were standardized according to the 2010 China census by age group and sex. The prevalence of obesity-related complications by body mass index (BMI) groups was calculated using logistic regression.

Results

There were 15 770 094 eligible participants (median age 40 years; mean BMI 24.1 kg/m²; 52.8% male). By Chinese BMI classification, 34.8% were overweight and 14.1% were obese. Overweight and obesity were more prevalent in male than female participants (standardized: overweight 40.2% vs. 27.4%; obesity 17.6% vs. 9.6%, respectively). The prevalence of assessed complications was higher in participants with overweight/obesity versus those with normal BMI (P < 0.001 for trends). The most prevalent complications in participants with overweight/obesity were fatty liver disease, prediabetes, dyslipidaemia and hypertension. The number of complications increased with higher BMI.

Conclusions

Overweight/obesity and related complications are highly prevalent in this population. These data may better inform management and prevention public health strategies in China.     

超重及肥胖者血浆游离脂肪酸浓度与动态血压的关系

目的:探讨超重及肥胖者血浆游离脂肪酸(FFA)水平及动态血压的关系。方法:检测57例超重及肥胖者和56例体重正常者血浆FFA、血脂、血糖、胰岛素(INS)浓度,并检查24h动态血压。结果:超重及肥胖者血浆FFA、甘油三酯(TG)、血糖、INS及24h平均血压水平均较对照组显著升高(P<0.01),且超重与肥胖者血浆FFA浓度与24h平均血压呈正相关,SBP(r=0.406,P<0.01),DBP(r=0.361,P<0.01)。结论:超重及肥胖者血浆游离脂肪酸浓度升高,可能与高血压的发病有关。     

Epidemiologic surve of blood lipid level among 1401 residents aged≥60 years in rong-gui community

Objectives To investigate prevalence of blood lipid level among 1401 residents aged≥60 years in rong-gui community.Methods 1401 ones(579 males,822 females, (68.12±6.64)years Of total 1503 residents aged≥60 years in the 2 villages which were randomly exampled in rong-gui community were investigated.867 ones aged among 60-69 years(61.9%),430 ones aged among 70-79 years (30.7%),104 ones aged≥60 years(7.4%).Investigative items included age,sex,total cholesterol(TC),triglyceride (TG),body height,body weight,waist circumference(WC), hip circumference(HC),fasting plasma glucose(FG),blood pressure,history of past illness,body mass index(BMI), waist hip ratio(WHR),waist height ratio(WHtR).Results (l)Of total 1401 residents,Prevalence of hyperlipemia were 42.8%,female were signifleanfly higher than male(P<0.01), The difference among three age groups were not significant, the combined prevalence of hyperlipemia and borderline hyperlipemia was 80.1%.(2)The FG、BMI、SBP、DBP、WC、WHR、WHtR of residents with hyperlipemia were higher than ones with normal blood lipid level(P<0.01).(3)By Pearson correlation analysis,we found that hyperlipemia was obviously correlated with FG,BMI,WC,WHR,WHtR, SBP,DBP.Conclusions(1)Prevalence of hyperlipemia were 42.8%,female were signifleanfly higher than male.(2) hyperlipemia were obviously correlated with higher FG、BMI、WC、WHR、WHtR、SBP、DBP.     

Fatty liver with metabolic disorder,such as metabolic dysfunction‐associated fatty liver disease,indicates high risk for developing diabetes mellitus

IntroductionNonalcoholic fatty liver disease (NAFLD) is diagnosed after excluding other liver diseases. The pathogenesis of NAFLD when complicated by other liver diseases has not been established completely. Metabolic dysfunction‐associated fatty liver disease (MAFLD) involves more metabolic factors than NAFLD, regardless of complications with other diseases. This study aimed to clarify the effects of fatty liver occurring with metabolic disorders, such as MAFLD without diabetes mellitus (DM), on the development of DM.Materials and MethodsWe retrospectively assessed 9,459 participants who underwent two or more annual health check‐ups. The participants were divided into the MAFLD group (fatty liver disease with overweight/obesity or non‐overweight/obesity complicated by metabolic disorders), simple fatty liver group (fatty liver disease other than MAFLD group), metabolic disorder group (metabolic disorder without fatty liver disease), and normal group (all other participants).ResultsThe DM onset rates in the normal, simple fatty liver, metabolic disorder, and MAFLD groups were 0.51, 1.85, 2.52, and 7.36%, respectively. In the multivariate analysis, the MAFLD group showed a significantly higher risk of DM onset compared with other three groups (P < 0.01). Additionally, the risk of DM onset was significantly increased in fatty liver disease with overweight/obesity or pre‐diabetes (P < 0.01).ConclusionsFatty liver with metabolic disorders, such as MAFLD, can be used to identify patients with fatty liver disease who are at high risk of developing DM. Additionally, patients with fatty liver disease complicated with overweight/obesity or prediabetes are at an increased risk of DM onset and should receive more attention.     

Association of nonalcoholic fatty liver disease with insulin resistance

BACKGROUND AND PURPOSE: Nonalcoholic fatty liver disease is frequently associated with type 2 diabetes mellitus, obesity, and dyslipidemia, but some patients have normal glucose tolerance or normal weight. We tested the hypothesis that there is an association between nonalcoholic fatty liver disease and insulin resistance that is independent of diabetes and obesity. SUBJECTS AND METHODS: We measured anthropometric and metabolic variables in 46 patients with chronically elevated serum aminotransferase levels, "bright liver" on ultrasound scan, and normal glucose tolerance. Indexes of insulin resistance and secretion were determined using the homeostasis model assessment method. They were compared with 92 normal subjects who were matched for age and sex. RESULTS: Patients with nonalcoholic fatty liver disease were characterized by fasting and glucose-induced hyperinsulinemia, insulin resistance, postload hypoglycemia, and hypertriglyceridemia. Insulin resistance [odds ratio (OR) = 15 per percent increase, 95% confidence interval (CI): 3.0 to 70], fasting triglyceride level (OR = 3.1 per mmol/liter increase, 95% CI: 1.1 to 8.9), 180-minute blood glucose level (OR = 4.3 per mmol/ liter decrease, 95% CI: 1.6 to 12), and average insulin concentration in response to oral glucose (OR = 3.0 per 100 pmol/liter increase, 95% CI: 1.5 to 6.2) were independently associated with nonalcoholic fatty liver disease. The exclusion of overweight and obese subjects did not change the results. CONCLUSION: Nonalcoholic fatty liver disease is associated with insulin resistance and hyperinsulinemia even in lean subjects with normal glucose tolerance. Genetic factors that reduce insulin sensitivity and increase serum triglyceride levels may be responsible for its development.