Metabolic syndrome is a risk factor for nonalcoholic fatty liver disease: evidence from a confirmatory factor analysis and structural equation modeling

F.-Y. Shi, W.-F. Gao, E.-X. Tao, H.-Q. Liu, S.-Z. Wang

Department of Health Statistics, School of Public Health, Weifang Medical College, Weifang, Shandong, China. wangsz@wfmc.edu.cn

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• Gastroenterology

OBJECTIVE: It has been demonstrated that nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome (MS). This study used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to characterize the relationship between MS and NAFLD.

PATIENTS AND METHODS: A cross-sectional study was performed on 3440 NAFLD patients. Of the 3440 subjects, 1160 were diagnosed with MS. BMI, SBP, DBP, UN, Scr, UA, FPG, Fructosamine, TC, TG, lipoprotein alpha, HDL-C, LDL-C, ALT, AST, TP, albumin, globulins, TB, DB, ALP and GGT were measured. CFA was used to identify a latent structure of NAFLD and MS, respectively. SEM approach was used to analyze the latent relationship between MS and NAFLD.

RESULTS: Second-order CFA revealed that the observed variables for NAFLD could be loaded onto seven latent factors, which were further loaded together onto an unobserved NAFLD factor. CFA of MS showed that overweight, hyperglycemia, dyslipidemia, and hypertension clustered together under a single latent factor of MS. In both MS and NAFLD models, hypertension showed higher factor loading than other factors. Factor models of MS and NAFLD showed a good fit to the data. As a latent factor, MS was significantly associated with increased risk of NAFLD.

CONCLUSIONS: MS may be a risk factor of NAFLD. MS and its components may play important roles in the development of NAFLD.

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