Definitions
NAFLD was defined as hepatic steatosis proven by imaging or histology,
lack of secondary causes of hepatic fat accumulation, and no significant
alcohol consumption (weekly alcohol intake ≤210 g in men and ≤140 g in
women) [21]. Hypertension was defined by blood pressure ≥140/90
mmHg, use of anti-hypertensive medication, or a self-reported history of
hypertension. Diabetes was defined by fasting glucose ≥7.0 mmol/L, 2-h
glucose ≥11.1 mmol/L during an oral glucose tolerance test, use of
anti-diabetic medication, or a self-reported history of diabetes.
Elevated intestinal permeability was defined by elevated serum D-lactate
(≥15 U/L). HOMA-IR value was calculated as previously described
[22]. Metabolic therapy included lipid-lowering medicines (such as
simvastatin and metformin) and lifestyle modifications (healthy eating
and regular exercise).