Open Access Research article

Non-alcoholic and alcoholic Fatty Liver Disease - two Diseases of Affluence associated with the Metabolic Syndrome and Type 2 Diabetes: the FIN-D2D Survey

Anna Kotronen123*, Hannele Yki-Järvinen2, Satu Männistö4, Liisa Saarikoski1, Eeva Korpi-Hyövälti5, Heikki Oksa6, Juha Saltevo7, Timo Saaristo6, Jouko Sundvall8, Jaakko Tuomilehto9 and Markku Peltonen1

Author Affiliations

1 Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland

2 Department of Medicine, Division of Diabetes, University of Helsinki, Helsinki, Finland

3 Minerva Medical Research Institute, Helsinki, Finland

4 Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland

5 Department of Internal Medicine, South Ostrobothnia Central Hospital, Seinäjoki, Finland

6 Tampere University Hospital, Tampere, Finland

7 Department of Internal Medicine, Central Finland Central Hospital, Jyväskylä, Finland

8 Laboratory of Analytical Biochemistry, Department of Health and Functional Capacity, National Institute for Health and Welfare, Helsinki Finland

9 Department of Public Health, University of Helsinki, Finland

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BMC Public Health 2010, 10:237  doi:10.1186/1471-2458-10-237

Published: 10 May 2010



Non-alcoholic fatty liver disease (NAFLD) is known to be associated with the metabolic syndrome (MetS) and abnormal glucose tolerance. Whether alcoholic fatty liver disease (AFLD) is associated with similar metabolic abnormalities has not been examined in a population-based study. We aimed at assessing the prevalences of NAFLD and AFLD, and to examine to what extent these conditions are associated with MetS and abnormal glucose tolerance.


The cohort included 2766 Finnish subjects (45-74 years) from the population-based FIN-D2D survey. Features of insulin resistance, components of the MetS, glucose tolerance status by oral glucose tolerance test, serum liver enzyme concentrations, and daily alcohol consumption were assessed.


Subjects with NAFLD and AFLD were equally obese and had similar fasting and insulin concentrations. The prevalences of NAFLD and AFLD were 21% (95% CI: 19%-22%) and 7% (95% CI: 6%-8%). The MetS was slightly more prevalent in AFLD (73%) than in NAFLD (70%, p = 0.028), and type 2 diabetes was similarly prevalent in NAFLD and AFLD (24-25%). The MetS and type 2 diabetes were more prevalent in subjects with NAFLD or AFLD compared to subjects with normal LFTs (53% and 14%, p < 0.0001 for both).

Discussion and conclusion

In Finnish middle-aged population, the prevalence of NAFLD is 3-fold higher than that of AFLD. The prevalences of MetS and type 2 diabetes are, however, significantly increased in both NAFLD and AFLD compared to subjects with normal LFTs. Subjects with AFLD are thus similarly metabolically unhealthy as subjects with NAFLD.