Metabolic Syndrome in Adults with Nonalcoholic Fatty Liver Disease

Main Article Content

Zhahid Hassan
Muzamil Latief
Mahroosa Ramzan
Farhat Abbas
Summyia Farooq


fatty liver, metabolic syndrome, NAFLD


Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, obesity, and other features of metabolic syndrome. It is identified as the most common cause of liver enzyme derangement. Lately, NAFLD has generated interest in exploring treatment options, including weight loss and dietary interventions. An association of NAFLD with metabolic syndrome has been suggested in contemporary literature. In this study, we attempted to look into the association of NAFLD with metabolic syndrome. In this study, 80 adult NAFLD patients were recruited from a tertiary care hospital. Among these, 42 were males and 38 females with a mean age of 44.46±13.146 years (range 18–82 years). Grades of fatty liver and presence or absence of metabolic syndrome were studied in this patient population. Patients who did not qualify for the criteria of metabolic syndrome were placed in Group 1 and those who fulfilled the stated criteria were considered in Group 2. There were 29 (36.25%) patients in Group 1 and 51 (63.75%) in Group 2. All the patients in Group 1 were having Grade I fatty liver whereas patients in Group 2 were found to having varying grades of fatty liver, with six patients having Grade III fatty liver. We found statistically significant difference in various parameters of study (liver enzymes, high-density lipoprotein (HDL), triglycerides, and blood pressure) between Group 1 and Group 2. Ultrasound evidence of a fatty liver should be considered as a predictor of metabolic syndrome, and these patients must be investigated for the different components of metabolic syndrome so as to have early diagnosis and intervention to alter development of long-term metabolic disorders and their inherent complications.


Download data is not yet available.
Abstract 113 | PDF Downloads 55 HTML Downloads 16 XML Downloads 44


1. Yki-Järvinen H. Nonalcoholic fatty liver disease as a cause and a consequence of metabolic syndrome. Lancet Diabetes Endocrinol. 2014;2(11):901–10. 10.1016/S2213-8587(14)70032-4

2. National Cholesterol Education Program (NCEP). Expert panel on detection and treatment of high blood cholesterol in adults (Adult Treatment Panel III) third report. Circulation. 2002;1106:3143–421. 10.1161/circ.106.25.3143. PMid: 12485966

3. Kim D, Touros A, Kim WR. Nonalcoholic fatty liver disease and metabolic syndrome. Clin Liver Dis. 2018 Feb;22(1):133–40. 10.1016/j.cld.2017.08.010. PMid: 29128053

4. Godoy-Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: From obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020 Jul 14;12:60. 10.1186/s13098-020-00570-y. PMid: 32684985; PMCID: PMC7359287

5. Albhaisi S, Sanyal AJ. Gene-environmental interactions as metabolic drivers of nonalcoholic steatohepatitis. Front Endocrinol (Lausanne). 2021 May 10;12:665987. 10.3389/fendo.2021.665987. PMid: 34040583; PMCID: PMC8142267

6. Kotronen A, Westerbacka J, Bergholm R, Pietiläinen KH, Yki-Järvinen H. Liver fat in the metabolic syndrome. J Clin Endocrinol Metab. 2007 Sep;92(9):3490–7. 10.1210/jc.2007-0482

7. Völzke H, Robinson DM, Kleine V, Deutscher R, Hoffmann W, Lüdemann J, et al. Hepatic steatosis is associated with an increased risk of carotid atherosclerosis. World J Gastroenterol. 2005 Mar 28;11(12):1848–53. 10.3748/wjg.v11.i12.1848

8. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes. 2001 Aug;50(8):1844–50. 10.2337/diabetes.50.8.1844

9. Younossi ZM, Dhiel AM, Ong JP. NAFLD, an agenda for clinical research. Hepatology. 2002:35;746–52. 10.1053/jhep.2002.32483

10. Singh SP, Nayak S, Swain M, Rout N, Mallik RN, Agrawal O, et al. Prevalence of nonalcoholic fatty liver disease in coastal eastern India: A preliminary ultrasonographic survey. Trop Gastroenterol. 2004 Apr–Jun;25(2):76–9.

11. Hanley AJ, Williams K, Festa A, Wagenknecht LE, D’Agostino RB Jr, Haffner SM. Liver markers and development of the metabolic syndrome: The insulin resistance atherosclerosis study. Diabetes. 2005 Nov;54(11):3140–7. 10.2337/diabetes.54.11.3140

12. Wai-Sun V, Winnie W, Wong CWCG, Chan HLY. Prevalence of nonalcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: A population study using proton-magnetic resonance spectroscopy and transient elastography. Gut. August 2011;61(3):409–15. 10.1136/gutjnl-2011-300342

13. Nomura H, Kashiwagi S, Hayashi J, Kajiyama W, Tani S, Goto M. Prevalence of fatty liver in the general population of Okinawa, Japan. Jap J Med 1998 May;27(2):142–9. 10.2169/internalmedicine1962.27.142. PMid: 3047469.

14. Cortez, Pinto H, Camilu H, Bapista, et al. NAFLD, another feature of metabolic syndrome. Diabetes. 1996;36:185–92.

15. Shannon A, Alkhouri N, Carter-Kent C, Monti L, Devito R, Lopez R, et al. Ultrasonographic quantitative estimation of hepatic steatosis in children with NAFLD. J Pediatr Gastroenterol Nutr. 2011 Aug;53(2):190–5. 10.1097/MPG.0b013e31821b4b61

16. Yang S, Kwak S, Lee JH, Kang S, Lee SP. Nonalcoholic fatty liver disease is an early predictor of metabolic diseases in a metabolically healthy population. PLoS One. 2019 Nov 4;14(11):e0224626. 10.1371/journal.pone.0224626. PMid: 31682638; PMCID: PMC6827890

17. Goyal A, Arora H, Arora S. Prevalence of fatty liver in metabolic syndrome. J Family Med Prim Care. 2020 Jul 30;9(7):3246–50. 10.4103/jfmpc.jfmpc_1108_19. PMid: 33102278; PMCID: PMC7567270