on August 9, 2007
Published online before print August 9, 2007, doi: 10.1161/ATVBAHA.107.147538
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Submitted on May 4, 2007
Accepted on July 19, 2007
Fatty Liver. A Novel Component of the Metabolic Syndrome
Anna Kotronen and Hannele Yki-Järvinen *
From the Department of Medicine, Division of Diabetes (A.K., H.Y.-J.), University of Helsinki, and Minerva Medical Research Institute (A.K.), Helsinki, Finland.
* To whom correspondence should be addressed. E-mail: ykijarvi{at}cc.helsinki.fi.
Abstract—Although the epidemic of obesity has been accompanied by an increase in the prevalence of the metabolic syndrome, not all obese develop the syndrome and even lean individuals can be insulin resistant. Both lean and obese insulin resistant individuals have an excess of fat in the liver which is not attributable to alcohol or other known causes of liver disease, a condition defined as nonalcoholic fatty liver disease (NAFLD) by gastroenterologists. The fatty liver is insulin resistant. Liver fat is highly significantly and linearly correlated with all components of the metabolic syndrome independent of obesity. Overproduction of glucose, VLDL, CRP, and coagulation factors by the fatty liver could contribute to the excess risk of cardiovascular disease associated with the metabolic syndrome and NAFLD. Both of the latter conditions also increase the risk of type 2 diabetes and advanced liver disease. The reason why some deposit fat in the liver whereas others do not is poorly understood. Individuals with a fatty liver are more likely to have excess intraabdominal fat and inflammatory changes in adipose tissue. Intervention studies have shown that liver fat can be decreased by weight loss, PPAR
agonists, and insulin therapy.
Key words: liver fat • metabolic syndrome • nonalcoholic liver disease
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