C-peptide as a key risk factor for non-alcoholic fatty liver disease in the United States population

• Published in: World journal of gastroenterology : WJG Vol. 24; no. 32; pp. 3663 - 3670
• Main Authors: Atsawarungruangkit, Amporn, Chenbhanich, Jirat, Dickstein, George
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.08.2018
• Subjects: Adult; Alanine Transaminase - blood; C-Peptide - blood; Case-Control Studies; Fasting; Female; Humans; Insulin Resistance; Liver - diagnostic imaging; Liver - pathology; Logistic Models; Male; Middle Aged; Non-alcoholic Fatty Liver Disease - blood; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - pathology; Nutrition Surveys - statistics & numerical data; Prevalence; Retrospective Cohort Study; Risk Factors; Ultrasonography; United States; Waist Circumference; Insulin resistance; Fatty liver; Metabolic syndrome; C-peptide; Hepatosteatosis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v24.i32.3663

To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease (NAFLD) in United States population. Using the National Health and Nutrition Examination Survey (NHANES) 1988-1994, NAFLD participants aged 20 or greater without any other liver diseases were included in this study. Excessive alcohol intake is defined as > 2 drinks per day for males and > 1 drink per day for females. C-peptide and 27 other factors known to be associated with NAFLD ( ., age, gender, body mass index, waist circumference, race/ethnicity, liver chemistries, and other diabetes tests) were tested in both univariate and multivariate level using logistic regression with a -value 0.05. Of 18825 participants aged ≥ 20, 3235 participants ( = 3235) met inclusion criteria. There were 23 factors associated with NAFLD by univariate analysis. 9 factors, ranked by the highest change in pseudo , were found to be significant predictors of NAFLD in multivariate model: waist circumference, fasting C-peptide, natural log of alanine aminotransferase (ALT), total protein, being Mexican American, natural log of glycated hemoglobin, triglyceride level, being non-Hispanic white, and ferritin level. Together with waist circumference and ALT, fasting C-peptide is among three most important predictors of NAFLD in United States population in the NHANES data set. Further study is needed to validate the clinical utility of fasting C-peptide in diagnosis or monitoring insulin resistance in NAFLD patients.