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Nonalcoholic fatty liver disease in patients with metabolic syndrome in primary care

Objective: To analyse the relationship between Hepatic Steatosis, also known as Non-Alcoholic Fatty Liver disease (NAFLD) in patients with metabolic syndrome criteria and cardiovascular risk factors. Method: A cross-sectional study was performed to study a sample of 100 patients attending Primary Care with 2 or more cardiovascular risk factors and no alcohol consumption. For those who were selected a complete analysis was carried out, and they were assigned to the outpatient clinics for an abdominal ultrasound exam. It was assessed whether they had Hepatic Steatosis or not, and if so, it was classified into 3 grades (mild-moderate-severe). Subsequently, the following qualitative (sex, personal and family history of diabetes, hypertension, dyslipidemia, etc.) and quantitative (age, weight, height, body mass index, drug treatment, figures of analytical parameters, blood pressure and waist circumference) variables were collected. Results: 100 patients, 44 men and 56 women participated, with an average age of 61.84 ± 9.5 years. Men, 82% had Hepatic Steatosis: 28% Grade I, 38.7% Grade II and 16% Grade III. Women, 28.57% did not have Hepatic Steatosis. Of those who had Hepatic Steatosis: 30.35% were Grade I, 21.43% Grade II and 19.64% Grade III. 22% were overweight and 38% were obese. Only 22% and 18% had impaired systolic and diastolic blood pressure values respectively. 60% had impaired fasting glucose levels, but only 26% had altered glycosylated hemoglobin. Regarding lipid parameters 36% had hypertriglyceridemia, 41% hypercholesterolemia, 65% High LDL cholesterol and 16% low HDL cholesterol. Of the total study subjects, 23% had no Non-Alcoholic Hepatic Steatosis, 29% had mild hepatic Hepatic Steatosis, 29% moderate Hepatic Steatosis and 19% severe Hepatic Steatosis. 83% of patients had two or more criteria of metabolic syndrome. Conclusions: There is a close relationship between the incidence of Non-Alcoholic Hepatic Steatosis and cardiovascular risk factors in patients with metabolic syndrome. Therefore it is recommended that upon the appearance of these risk factors, liver should be tested.

Author(s): Pedro J Tarraga Lopez, Angel Celada Rodriguez, Alicia Sahuquillo, Juan Solera Albero, Jose Antonio Rodriguez Montes, Pilar Torres Moreno, Maria Loreto Tarraga Marcos, Ibrahim M Sade K