The clinical data including age, gender, history of drinking and alcohol intake were obtained from the clinical documents of endocrinology clinic. According to the routine protocol, the information of complete physical examination including height, weight, waist circumference (Wc), and blood pressure were recorded after overnight fasting for 12 h, and body mass index (BMI) was calculated by body weight (kg)/height squared (m2). The general laboratory tests (Japan Hitachi 7600 biochemical analyzer) included the levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA). Free triiodothyronine (FT3), free thyroxine (FT4), TSH, thyrotrophin receptor antibody (TRAb), fasting plasma insulin (f-INS), and hyper-sensitive C-reaction protein (HCRP) were also measured (electrochemiluminescence, Roche Diagnostics, Germany). Insulin resistance index (HOMA-IR) were calculated by FBG × fasting insulin / 22.5. All subjects received a ultrasonic examination performed with a GE Vivid7 ultrasound machine as described previously [16]. Briefly, in the sagittal liver/right kidney view of ultrasound images, a region of interest (ROI) in the liver parenchyma and the kidney cortex was selected. In the right liver intercostals view of ultrasound images, a ROI in the liver far-field region was selected. And then all images were analyzed-of by using NIHimage software to estimate the gray scale mean value of the pixels within the two ROIs and calculated the hepatic/renal echo-intensity ratio and hepatic echo-intensity attenuation rate. A 3D abdominal phantom Model was introduced to standardize the measured values of US H/R ratio and hepatic echo- intensity attenuation rate, finally we can compute the liver fat content as the following formula: Liver fat content (%) = 62.592 × US hepatic/renal ratio + 168.076 × US hepatic attenuation rate − 27.863. NAFLDwas defined in patients with liver fat content more than 9.15% according to our previous research [16]. .

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