Endocrinology and Metabolism

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Diabetes, obesity and metabolism
Characteristics of Metabolic Dysfunction-Associated Steatotic Liver Disease and Its Risk for Hepatic Fibrosis in 476,124 Korean Adults: A Cross-Sectional Study: Da Yeon Lee, Ji-Hee Ko, Han-Na Jang, Sun Joon Moon, Hye-Mi Kwon, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Eun-Jung Rhee; Endocrinol Metab. 2025;40(4):648-652. Published online March 27, 2025; DOI: https://doi.org/10.3803/EnM.2024.2281

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As the new terminology of metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with increased alcohol intake (MetALD) has emerged, the clinical significance of MASLD is increasing. This cross-sectional study analyzed 476,124 health checkup participants (2002–2022) to compare hepatic fibrosis risks across MASLD, MetALD, non-alcoholic fatty liver disease (NAFLD), and metabolic dysfunction-associated fatty liver disease (MAFLD). Steatotic liver was identified via ultrasonography, and fibrosis risk was assessed using aspartate aminotransferase to platelet ratio index and NAFLD fibrosis score. The prevalence of NAFLD, MAFLD, MASLD, and MetALD was 30.1%, 32.3%, 29.8%, and 3.0%, respectively, with a 27.9% overlap among three conditions. Participants with steatotic liver were predominantly male, with higher glucose, lipids, liver enzymes, and homeostasis model assessment of insulin resistance levels. Three disease definitions largely overlapped, with MASLD and NAFLD being very similar, while participants with MAFLD and MetALD showed increased fibrosis risk (clinical trial registration number: 2024-11-050).

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Associations between steatotic liver disease subtypes and incident diabetes in young Korean adults: A nationwide cohort study
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Original Article

Metabolic Abnormalities according to Severity of Non-alcoholic Fatty Liver Disease in Korean Adults.: H J Kim, D J Kim, S K Kim, S H Kim, Y M Rhee, C W Ahn, B S Cha, Y D Song, S K Lim, K R Kim, H C Lee, K B Huh; J Korean Endocr Soc. 2002;17(4):514-525. Published online August 1, 2002

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Abstract PDF: BACKGROUND
We evaluated the frequency of non-alcoholic fatty liver diseases, and the associations between the metabolic abnormalities and severity of non-alcoholic fatty liver disease in Korean adults using ultrasonography. METHODS: We examined 1074 Korean adults above the age of 30 years, comprising of 502 men and 572 women, participating in medical check-ups at the Health Promotion Center. Hepatitis B and C serologies were negative, and the average weekly alcohol intake was < or = 2 standard drinks. A standard interview, physical exam and biochemical study, were conducted, and an experienced operator carried out ultrasound liver studies. RESULTS: 522 of the subjects had non-alcoholic fatty liver disease, and the remaining 552 did not. The frequency in the men was higher than that in the women (57 vs 42%, p<0.05). The frequency of non-alcoholic fatty liver disease in the subjects without diabetes, obesity or dyslipidemia was 20%. We classified subjects into 4 groups: the controls (n=552) and those with mild (n=218), moderate (n=273) or severe fatty liver disease (n=31), according to their ultrasonographic findings. BMI, waist circumference, body fat, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, the total- to HDL-cholesterol ratio, impaired fasting glucose, hypertension and insulin resistance, were all significantly increased with the increased severity of non-alcoholic fatty liver disease (p<0.05). Following the multiple regression analyses, waist, alanine aminotransferase, HOMAIR, the total- to HDL-cholesterol ratio, aspartate aminotransferase and systolic blood pressure, were all associated with the severity of non-alcoholic fatty liver disease. Odd ratios of insulin resistance in the mild, moderate and severe non-alcoholic fatty liver disease were 14.7 (CI: 6.8~32.0), 6.9 (CI: 4.6~10.3) and 5.7 (CI3.6~8.8), respectively. The percentages of subjects with insulin resistance in each group were 7.6, 32.0, 36.0 and 55.0% (p<0.05), respectively. The percentages of subjects with risk of non-alcoholic steatohepatitis in each groups were 5.0, 21.6, 27.8 and 58.1% (p<0.05) respectively. CONCLUSION: The frequency of non-alcoholic fatty liver disease was relatively high in Korean adults. Proportional differences in metabolic abnormalities, relation to the severity of non-alcoholic fatty liver disease, were found by ultrasonography.

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