Current smokers were defined as those who had smoked at least one cigarette per day during the previous year. Physical activity

was measured (as hours of exercise per week) by self report using the questionnaire. Laboratory evaluations included aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), total serum cholesterol, serum triglycerides, serum high-density lipoprotein (HDL) cholesterol, fasting glucose, serum creatinine, C-reactive protein, hepatitis B surface antigen, and an antibody to hepatitis C virus. Venous blood samples were taken from all subjects before 10 AM after a 12-hour overnight fast. All laboratory determinations were performed using standard laboratory methods. We calculated the estimated glomerular filtration rate according to the Modification of Diet in Renal Disease (MDRD) equation as follows: glomerular click here filtration rate (mL/minute/1.73 m2) = 186 × serum creatinine−1.154 Fulvestrant cell line × age−0.203 × 0.742 (if female) × 1.210 (if African American).21 Systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg and/or previous use of antihypertensive medication were used to define hypertension. Subjects with fasting plasma glucose levels ≥126 mg/dL and/or treatment with a hypoglycemic agent or insulin were defined as having diabetes mellitus.

We divided participants with ultrasonography diagnosed NAFLD depending on the status of ALT (elevated ALT was defined as ALT > 30 U/L for men and > 19 U/L for women).22 Hepatic ultrasonography was performed by experienced radiologists who Anacetrapib were blinded to the laboratory and clinical details of the subjects at the time of the procedure. Hepatic ultrasonography (Acuson Sequoia 512; Siemens, Mountain View,

CA) was used to diagnose fatty liver. The diagnosis of fatty liver was made on the basis of characteristic ultrasonographic features consistent with “bright liver” and evident contrast between hepatic and renal parenchyma, vessel blurring, focal sparing, and narrowing of the lumen of the hepatic veins.23-25 A CT scan of the coronary artery was performed using a 16-slice multidetector CT system (Somatom Sensation 16; Siemens Medical Solutions, Forchheim, Germany) at SNUH-HCS and a 64-channel multidetector CT system (Brilliance 64; Philips Medical Systems, Best, Netherlands) at SNUBH-HPC. CAC scans were acquired using the standard procedure of prospective electrocardiography-triggered scan acquisition with a tube voltage of 120 kV and 110 effective mA with a 200-mm field of view.26 The data were reconstructed to a 3-mm-thick slice with a 400-ms acquisition window. The CAC score was calculated using a CT software program (Rapidia 2.8; INFINITT, Seoul, Korea) with the Agatston method.27 We used a previously described method for VAT area measurement in cross-sectional CT images.