Objectives To determine whether fatty liver is associated with risk factors of metabolic syndrome independently of body mass index (BMI). Design A cross-seectional study. Setting and Participants A total of 8,555 subjects, who consulted our institute for health screening between January 2001 and December 2001. Measurement and Results Among the risk factors of metabolic syndrome, overweight, hyperlipidemia, hyperglycemia, and hypertension, in that order, were significantly associated with fatty

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... iver in multiple logistic regression analyses. The odds ratios (95% Confidence Interval) were 6.Fatty liver was significantly associated with an increase in the risk factors for metabolic syndrome. However, the increase in the odds ratios was rather limited on multivariate analyses when BMI was added compared to that on univariate analyses; nevertheless, subjects with 4 risk factors for metabolic syndrome had approximately 4 times (95% Confidence Interval: 2.1-6.5) the risk of fatty liver compared with that of those without any risk factors. BMI increased the odds ratios of having 2 or more risk factors for metabolic syndrome in subjects both with and without fatty liver. Subjects with fatty liver had approximately 2 times the risk of having 2 or more risk factors compared with that of those without fatty liver in each BMI group. Conclusions These results suggest that individuals with fatty liver, even if they were not overweight, are probably complicated by the risk of metabolic syndrome, that is, a fatty liver per se also has clinical significance. However, since these pathological findings were also dependent on BMI, we believe that it is possible to reduce the risk of metabolic syndrome by reducing body weight, even if a person has a fatty liver.