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Abdominal obesity (defined in males as a waist/hip ratio >0.95 and in females as >0.8),14 was found in 63% of the patients. Waist circumference was 101±6.7 and 105±7.7 cm for essential fatty acid male and female patients, respectively, and waist/hip ratio was 1.0±0.1 essential fatty acid for both groups. Hypertension (140/90 mmHg) was present in 58%, but drug therapy, where used, did not include medications known to be associated with essential fatty acid fatty liver or dyslipidaemia. The most consistent abnormality of serum liver enzymes (Table 1), detected in almost all patients, was an elevation of about two-fold in ALT, whereas increased AST levels were noted in 77% of the patients, but to a lesser degree. Elevated GGT levels were found in 52% of the patients, sometimes accompanied by an increased serum alkaline phosphatase in 15%. None of the patients had bilirubinaemia, reduced serum albumin levels or prolongation of the prothrombin time. All patients had findings consistent with fatty infiltration by ultrasonography which is a highly accurate tool for the diagnosis of fatty liver.4,21
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