7-fold higher in patients with diastolic hypertension.17,18 In addition, Donati et al. reported that even in non-obese, non-diabetic high blood pressure patients, the prevalence of fatty liver was three times higher than in healthy individuals. Further such patients showed high levels of HOMA-IR, indicating insulin resistance.19 The pathogenesis of hypertension is influenced by various CP-673451 supplier factors, such as salt intake, and also

is associated with insulin resistance. It is important to know that even non-obese high blood pressure patients with no other lifestyle-related diseases are likely to develop NAFLD if they have insulin resistance. In Japan, large-scale studies on hypertension and NAFLD are currently underway, including among subjects with chronic kidney disease (CKD). Recently, we reported the prevalence of CKD in 174 NAFLD patients. The prevalence of CKD was significantly higher in NASH patients (19 of 92; 21%) than SS patients (5 of 82; 6%), and associated with a higher body mass index and the presence of hypertension.20 Dyslipidemia is a generic term describing a clinical condition in which the levels of cholesterol esters or triglycerides increase in the Gefitinib chemical structure blood: high levels of triglycerides (150 mg/dL or higher) and LDL cholesterol (140 mg/dL or higher), with decreased levels of HDL cholesterol (less than 40 mg/dL) are each risk factors MCE for other diseases. In the

National Health and Nutrition Examination Survey conducted in 2007, the percentage of subjects suspected of dyslipidemia (including 9.7%

currently under treatment) was 44.1%, and that of normal subjects was 55.9%. Dyslipidemia in NAFLD often involves hypertriglyceridemia and decreased blood levels of HDL cholesterol. This is due to the insufficient effects of lipoprotein lipase (LPL), which leads to a decreased metabolism of triglyceride-rich lipoproteins into HDL cholesterol. In addition, there is also an increased synthesis of very-low density lipoprotein (VLDL). The incidence of pediatric NAFLD in Japan is increasing in proportion to the increase in the prevalence of childhood obesity. In a previous study conducted on children aged 6–15 years, Tominaga et al. reported that the prevalence of NAFLD was 3.4% in children aged 6–10 years and 5.2% in those aged 11–15 years.21 In addition, the prevalence of NAFLD in children who met the diagnostic criteria for pediatric metabolic syndrome was 40.0% in those diagnosed with pre-metabolic syndrome, and 76.8% in those who fulfilled the criteria for metabolic syndrome. Tsuruta et al. also reported that, in a similar study conducted in 2007 on 288 junior high school students (13–15 years old), 5.9% were obese, the prevalence of NAFLD was 4.5%, and obesity and ALT levels of 30 IU/L or higher were independent risk factors for NAFLD in children.