Visceral fat and insulin resistance as predictors of non-alcoholic steatohepatitis

Table 1 Demographic data (means ± SD)

	NASH(n = 30)	Control(n = 30)	P-value
Mean age (yr)	53.7 (7.0)	51.0 (6.7)
Female (n, %)	25 (83.3)	26 (86.7)
Systolic blood pressure (mmHg)	137.8 (15.6)	123.4 (16.5)	0.001
Diastolic blood pressure (mmHg)	81.6 (7.5)	77.1 (9.7)	0.048
Body mass index (BMI) (kg/m2)	27.7 (3.9)	23.9 (3.3)	< 0.001
BMI classification1 (n, %)
Normal	2 (6.7)	12 (40)	< 0.001
Pre-obesity	2 (6.7)	8 (26.7)
Obesity classI	18 (60)	9 (30)
Obesity class II	8 (26.7)	1 (3.3)
Triceps skin fold (mm)	28.9 (6.0)	25.0 (6.5)	0.02
Waist circumference (cm)	89.1 (8.9)	76.4 (8.0)	< 0.001
Waist to hip ratio	0.87 (0.1)	0.81 (0.1)	< 0.001
Fat mass (kg)	21.2 (5.1)	15.8 (4.5)	< 0.001
Abdominal fat (x 103, g)	6.0 (1.4)	3.8 (1.5)	< 0.001
Visceral fat area (cm2)	147.8 (38.7)	92.9 (29.9)	< 0.001
Subcutaneous fat area (cm2)	272.2 (85.1)	189.7 (64.9)	< 0.001
Visceral to total fat ratio	0.36 (0.09)	0.34 (0.10)
Visceral to subcutaneous fat ratio	0.60 (0.23)	0.55 (0.33)

NASH: non-alcoholic steatohepatitis.

¹By the definition of Asia BMI.

Table 2 Biochemical tests (means ± SD)

	NASH	Control	P-value
AST (IU/L)	70.9 (40.4)	19.9 (5.6)	< 0.001
ALT (IU/L)	116.1 (45.2)	35.2 (9.7)	< 0.001
AST/ALT	0.6 (0.2)	0.6 (0.2)
Glucose (mmol/L)	6.8 (2.8)	5.0 (0.4)	0.02
Insulin (pmol/L)	108.6 (55.0)	38.6 (20.7)	< 0.001
HOMA-IR	4.8 (3.7)	1.2 (0.7)	< 0.001
Cholesterol (mmol/L)	5.4 (0.9)	5.1 (0.5)
LDL-C (mmol/L)	3.4 (0.9)	3.6 (0.4)
HDL-C (mmol/L)	1.2 (0.3)	1.2 (0.3)
Triglyceride (mmol/L)	1.7 (0.7)	0.8 (0.5)	< 0.001
Uric acid (μmol/L)	317.4 (83.8)	263.5 (53.9)	0.01

NASH: non-alcoholic steatohepatitis.

Table 3 Univariate analysis for predictive factors of NASH

Factor	Odds ratio	95% CI	P-value
Hypertension	6.50	1.82-23.21	0.004
Body mass index (kg/m2)	1.38	1.14-1.67	0.001
Triceps skin fold (mm)	1.11	1.01-1.21	0.024
Waist circumference (cm)	1.18	1.09-1.29	< 0.001
Fat mass (kg)	1.28	1.11-1.47	0.001
Visceral fat area > 158 (cm2)	19.33	2.31-161.55	< 0.001
Subcutaneous fat area (cm2)	1.01	1.01-1.02	0.001
Glucose (mmol/L)	2.88	1.29-6.43	0.01
Insulin > 11.9 (pmol/L)	58.00	6.87-489.58	< 0.001
HOMA-IR > 2.8	38.50	7.41-199.87	< 0.001
Triglyceride > 1.70 (mmol/L)	19.33	2.31-161.55	0.006
Uric acid (μmol/L)	1.97	1.12-3.47	0.019

Table 4 Correlation of visceral fat with anthropometric and metabolic parameters

Parameter	Correlation coefficient (r)	P-value
Systolic blood pressure	0.31	0.02
Diastolic blood pressure	0.35	0.006
Body mass index	0.66	< 0.001
Abdominal fat	0.74	< 0.001
Glucose	0.39	0.002
Insulin	0.47	< 0.001
HOMA-IR	0.47	< 0.001
Triglyceride	0.38	0.003

Table 5 Univariate analysis for risk factors of advanced stage of NASH

Factor	Odds ratio	95% CI	P-value
Waist-to-hip ratio > 0.88	4.57	0.90-23.14
AST/ALT ratio > 0.65	12.25	1.27-118.36	0.03
HOMA-IR > 3.5	7.56	1.50-38.15	0.014
Grading of portal inflammation	4.3	1.31-14.08	0.016
Grading of NASH	4.0	1.18-13.51	0.026
Grading of steatosis	1.02	0.38-2.73