부산대학교 도서관

Objective: In patients diagnosed with nonalcoholic fatty liver disease (NAFLD) an appropriate method of identifying those with advanced fibrosis is required. It has been reported that diabetes is involved in the progression of fibrosis in NAFLD and that the FIB-4 index is useful in predicting fibrosis progression in the liver. Clarifying associations with glucose intolerance and other factors in cases of NAFLD found in health check-ups was therefore made the objective of the present study. Methods:The subjects were 1,638 persons diagnosed with NAFLD and they were assigned to 4 groups (A-D) depending on the degree of glucose intolerance based on FBS and HbA1c as follows: A Group - FBS < 100 mg/dL and HbA1c ≤5.5%; B Group - FBS 100 - 109mg/dL or HbA1c 5.6 - 5.9%; C Group - FBS 110 - 125 mg/dL or HbA1c 6.0 - 6.4%; D Group - FBS ≥126 mg/dL or HbA1c ≥ 6.5%. The groups were compared with regard to age, gender, abdominal circumference, blood pressure, dyslipidemia, platelets, liver function and FIB-4 index. Results: Age and FIB-4 index in the B, C and D Groups were significantly higher as compared with the A Group and there was a significant difference in liver function between the A and D Group. Regarding presence of metabolic syndrome factors, there were significant differences in blood pressure among all groups, between the A Group and D Group regarding abdominal circumference and between the A Group and C and D Groups regarding dyslipidemia.Conclusion: The results suggested that presence of metabolic syndrome factors was correlated with degree of glucose intolerance. They also suggested an association between a high FIB-4 index or low platelets and progression of liver fibrosis. The use of glucose intolerance and the FIB-4 index were therefore considered to be in important in identifying persons with advanced NAFLD in health check-ups.