This study represents
an analysis of the third NHANES data (1988-1994, the National Center for Health Statistics, the Centers for Disease Control and Prevention [CDC]), including the follow-up mortality data (NHANES III-Linked Mortality Files). NHANES employs a stratified, multistage, clustered probability sampling design to reach a representative sample of the noninstitutionalized civilian selleck inhibitor population in the United States. Overall, 14,797 adult (20-74 years of age) participants of the NHANES III survey examined laboratory tests at a mobile examination center (Fig. 1). Of those, subjects with excessive alcohol consumption (>21 drinks/week in men and >14 drinks/week in women),17 viral hepatitis (positive serum hepatitis B surface antigen and positive serum hepatitis C antibody), iron overload (transferrin saturation ≥50%),
or pregnant women were excluded (n = 1,621). Of the remaining 13,176 participants, hepatic steatosis could be evaluated in 12,317 (93.5%). We removed subjects in whom data on serum aminotransferase, mortality status, or body mass index (BMI), waist circumference, albumin (ALB), or PLT count were missing. Thus, the final study sample consisted of 11,154 Selleckchem EPZ 6438 adults with complete data. The original survey was approved by the CDC’s Institutional Review Board, and all participants provided written informed
consent to participate. This analysis per se was deemed exempt by the institutional selleck products review board of the Mayo Foundation, because the data set used in the analysis was completely deidentified. A wide array of demographic, lifestyle, and dietary information as well as anthropometric assessment and comprehensive laboratory data were available in the data set. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg and/or previous use of antihypertensive medication. Diabetes mellitus was diagnosed in subjects with history of diabetes diagnosis and/or treatment with a hypoglycemic agent or insulin. Insulin resistance (IR) was defined by the top quartile of the homeostasis model assessment of IR (HOMA-IR; fasting glucose × fasting insulin/405) among subjects without diabetes in each gender.