AIM:To investigate the prevalence of fatty liver discovered upon physical examination of Chinese patients and determine the associated clinical characteristics.METHODS:A total of 3433 consecutive patients who received physical examinations at the Huangpu Division of the First Affiliated Hospital at Sun Yat-sen University in Guangzhou,China from June 2010 to December2010 were retrospectively enrolled in the study.Results of biochemical tests,abdominal ultrasound,electrocardiography,and chest X-ray were collected.The diagnosis of fatty liver was made if a patient met any two of the three following ultrasonic criteria:(1)liver and kidney echo discrepancy and presence of an increased liver echogenicity(bright);(2)unclear intrahepatic duct structure;and(3)liver far field echo decay.RESULTS:The study population consisted of 2201males and 1232 females,with a mean age of 37.4±12.8 years.When all 3433 patients were considered,the overall prevalence of hyperlipidemia was 38.1%,of fatty liver was 26.0%,of increased alanine aminotransferase(ALT)and/or aspartate aminotransferase(AST)levels was 11.9%,of gallstone was 11.4%,of hyperglycemia was 7.3%,of hypertension was 7.1%,and of hyperuricemia was 6.2%.Of the 2605 patients who completed the abdominal ultrasonography exam,677(26.0%)were diagnosed with fatty liver and the prevalence was higher in males(32.5%vs females:15.3%,P<0.001).The overall prevalence of fatty liver increased with age,with the peak prevalence(39.5%)found in the 60 to 70-year-old age group.Among patients between the ages of 18 to 50-year-old,the prevalence of fatty liver was significantly higher in males(20.2%vs females:8.7%,P<0.001);the difference in prevalence between the two sexes in patients>50-year-old did not reach statistical significance.Only 430 of the patients diagnosed with fatty liver had complete information;among those,increased ALT and/or AST levels were detected in only 30%,with all disturbances being mild or moderate.In these 430 patients,the overall prevalence of hypertriglyceridemia was 31.4%,of mixed type hyperlipidemia was 20.9%,of hypercholesterolemia was 12.3%,of hyperglycemia was 17.6%,of hypertension was 16.0%,of hyperuricemia was 15.3%,and of gallstone was 14.4%.Again,the prevalences of hypertriglyceridemia and hyperuricemia were higher in males(hypertriglyceridemia,36.0%vs females:12.0%,P<0.05;hyperuricemia,17.3%vs females:7.2%,P<0.05);in contrast,however,the prevalences of mixed type hyperlipidemia and hypercholesterolemia was higher in females(mixed type hyperlipidemia,18.7% vs females:30.1%,P<0.05,hypercholesterolemia,9.5%vs females:24.1%,P<0.05).Finally,comparison of the fatty liver group to the non-fatty liver group showed that prevalences of hyperlipidemia,hyperglycemia,hypertension,and hyperuricemia were higher in the former(all P<0.01).CONCLUSION:A high prevalence of fatty liver is detected upon physical examination in Guangzhou,and the primary associated clinical findings are hyperlipidemia,hyperglycemia,hypertension,and hyperuricemia.