Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 14, 2013; 19(22): 3375-3384
Published online Jun 14, 2013. doi: 10.3748/wjg.v19.i22.3375
What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?
Giovanni Tarantino, Carmine Finelli
Giovanni Tarantino, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, 80131 Naples, Italy
Giovanni Tarantino, Fondazione Pascale, Cancer Research Center of Mercogliano, 83013 Mercogliano, Italy
Carmine Finelli, Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, 80035 Potenza, Italy
Author contributions: Authors equally contributed to drafting the paper.
Correspondence to: Giovanni Tarantino, Professor, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy.
Telephone: +39-81-7462024 Fax: +39-81-7462024
Received: November 8, 2012
Revised: January 16, 2013
Accepted: January 23, 2013
Published online: June 14, 2013

Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middle- to long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS?

Keywords: Non-alcoholic fatty liver disease, Metabolic syndrome, Nonalcoholic steatohepatitis, Ultrasonography, Criteria