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Wang X, Liu J, Yu K, Huang Z, Liu H, Li X. Association between TyG-related parameters and NAFLD risk in Japanese non-obese population. Sci Rep 2025; 15:7119. [PMID: 40016248 PMCID: PMC11868368 DOI: 10.1038/s41598-025-88478-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 01/28/2025] [Indexed: 03/01/2025] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) constitutes a substantial proportion of cases among the non-obese population, yet it is frequently overlooked. Studies investigating the association between triglyceride-glucose (TyG)-related parameters (TyG-BMI, TyG-WC, TyG-WHtR) and NAFLD in non-obese individuals is limited. Thus, this study aims to investigate the association between TyG-related parameters and NAFLD in non-obese individuals to improve early detection and intervention strategies for NAFLD in this population. A cross-sectional analysis was conducted using data from the NAFLD database, including 11,987 participants who underwent health examinations between 2004 and 2015. Logistic regression models were employed to evaluate the relationship between TyG-related parameters and NAFLD risk, incorporating cubic spline functions and smooth curve fitting to identify potential nonlinear relationships. ROC curve analysis was conducted to assess the predictive performance of thee parameters. After controlling for confounding variables, the incidence of NAFLD in non-obese individuals increased with higher TyG-related parameters. Notably, nonlinear relationships between the TyG index and its related parameters regarding NAFLD risk were identified. The areas under the ROC curve for the TyG index and its related parameters were 0.7984, 0.8553, 0.8584, and 0.8353, respectively. Importantly, the predictive ability of the TyG index and its related parameters was stronger in the female population than in that of males. A positive and nonlinear relationship exists between the TyG-related parameters in relation to the risk of NAFLD. The TyG-related parameters exhibit predictive capabilities for NAFLD, with TyG-related parameters demonstrating greater strength than the TyG index itself.
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Affiliation(s)
- Xiuli Wang
- Department of Gastroenterology, The First People's Hospital of Chenzhou, Chenzhou, 423001, China
| | - Jie Liu
- Department of Emergency Medicine, Shenzhen New Frontier United Family Hospital, Shenzhen, 518000, China
| | - Ke Yu
- Department of Respiratory and Critical Care Medicine, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Zhenhua Huang
- Department of Emergency Medicine, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
| | - Hanxiong Liu
- Department of Gastroenterology, The First People's Hospital of Chenzhou, Chenzhou, 423001, China.
| | - Xiang Li
- Department of Medical Ultrasonics, Shenzhen Pingle orthopaedic hospital, Shenzhen, 518000, China.
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Mansour A, Pourhassan S, Gerami H, Mohajeri‐Tehrani MR, Salahshour M, Abbasi A, Madreseh E, Sajjadi‐Jazi SM. Regional fat distribution and hepatic fibrosis and steatosis severity in patients with nonalcoholic fatty liver disease and type 2 diabetes. Obes Sci Pract 2024; 10:e777. [PMID: 38957476 PMCID: PMC11215980 DOI: 10.1002/osp4.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
Background Epidemiologic findings suggest that measures of body fat distribution predict health outcomes independent of the overall body fat assessed by body mass index (BMI). This study aimed to evaluate the associations of overall and regional body fat with the severity of hepatic steatosis and fibrosis in type 2 diabetic patients with non-alcoholic fatty liver disease. Methods Bioelectric impedance analysis and two newly developed anthropometric indices, namely, A Body Shape Index (ABSI) and Body Roundness Index (BRI), were used to estimate the body fat. Based on fibroscan parameters, significant hepatic fibrosis and severe steatosis were defined as ≥F2 and >66%, respectively. Results Higher total body fat (odds ratio [OR] 1.107, 95% confidence intervals (CI) 1.038-1.182, p = 0.002), trunk fat (OR 1.136, 95% CI 1.034-1.248, p = 0.008) and leg fat (OR 1.381, 95% CI 1.139-1.674, p = 0.001) were associated with liver fibrosis. However, in contrast to the total body fat (OR 1.088, 95% CI 1.017-1.164, p = 0.014) and leg fat (OR 1.317, 95% CI 1.066-1.628, p = 0.011), the trunk fat was not associated with severe hepatic steatosis. BRI performed better than trunk, leg and total body fat in predicting hepatic steatosis (OR 2.186, 95% CI 1.370-3.487, p = 0.001) and fibrosis (OR 2.132, 95% CI 1.419-3.204, p < 0.001). Moreover, the trunk to leg fat ratio and ABSI were not independent predictors of either steatosis or fibrosis (p > 0.05). Conclusion BRI revealed a superior predictive ability for identifying the degree of hepatic steatosis and stiffness than other obesity indices. Additionally, higher levels of adiposity in the trunk, legs, and overall body were linked to an increased risk of developing liver fibrosis. Although trunk fat did not show an association with severe hepatic steatosis, an increase in leg and total fat was related to liver steatosis.
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Affiliation(s)
- Asieh Mansour
- Endocrinology and Metabolism Research CenterEndocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Saeed Pourhassan
- Department of Internal MedicineShariati HospitalTehran University of Medical SciencesTehranIran
| | - Hadis Gerami
- Endocrinology and Metabolism Research CenterEndocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical SciencesYazdIran
| | - Mohammad Reza Mohajeri‐Tehrani
- Endocrinology and Metabolism Research CenterEndocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Marziye Salahshour
- Department of Internal MedicineShariati HospitalTehran University of Medical SciencesTehranIran
| | - Ali Abbasi
- Department of CardiologyShariati HospitalTehran University of Medical SciencesTehranIran
| | - Elham Madreseh
- Department of Epidemiology and BiostatisticsTehran University of Medical SciencesTehranIran
| | - Sayed Mahmoud Sajjadi‐Jazi
- Endocrinology and Metabolism Research CenterEndocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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Jeong S, Park SJ, Na SK, Park SM, Song BC, Oh YH. Validity of fatty liver prediction scores for diagnosis of fatty liver by Fibroscan. Hepatobiliary Pancreat Dis Int 2024; 23:353-360. [PMID: 36870896 DOI: 10.1016/j.hbpd.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The Korea National Health and Nutrition Examination Survey nonalcoholic fatty liver disease (K-NAFLD) score was recently developed with the intent to operationally define nonalcoholic fatty liver disease (NAFLD). However, there remained an external validation that confirmed its diagnostic performance, especially in patients with alcohol consumption or hepatitis virus infection. METHODS Diagnostic accuracy of the K-NAFLD score was evaluated in a hospital-based cohort consisting of 1388 participants who received Fibroscan®. Multivariate-adjusted logistic regression models and the contrast estimation of receiver operating characteristic curves were used for validation of the K-NAFLD score, fatty liver index (FLI), and hepatic steatosis index (HSI). RESULTS K-NAFLD-moderate [adjusted odds ratio (aOR) = 2.53, 95% confidence interval (CI): 1.13-5.65] and K-NAFLD-high (aOR = 4.14, 95% CI: 1.69-10.13) groups showed higher risks of fatty liver compared to the K-NAFLD-low group after adjustments for demographic and clinical characteristics, and FLI-moderate and FLI-high groups revealed aORs of 2.05 (95% CI: 1.22-3.43) and 1.51 (95% CI: 0.78-2.90), respectively. In addition, the HSI was less predictive for Fibroscan®-defined fatty liver. Both K-NAFLD and FLI also demonstrated high accuracy in the prediction of fatty liver in patients with alcohol consumption and chronic hepatitis virus infection, and the adjusted area under curve values were comparable between K-NAFLD and FLI. CONCLUSIONS Externally validation of the K-NAFLD and FLI showed that these scores may be a useful, noninvasive, and non-imaging modality for the identification of fatty liver. In addition, these scores also predicted fatty liver in patients with alcohol consumption and chronic hepatitis virus infection.
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Affiliation(s)
- Seogsong Jeong
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam 13488, Korea
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea
| | - Seong Kyun Na
- Department of Internal Medicine, Inje University College of Medicine, Seoul 50834, Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea; Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Byung-Cheol Song
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Korea; Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong 14353, Korea.
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Han SK, Seo MJ, Lee T, Kim MY. Effectiveness of the ALT/AST ratio for predicting insulin resistance in a Korean population: A large-scale, cross-sectional cohort study. PLoS One 2024; 19:e0303333. [PMID: 38758828 PMCID: PMC11101110 DOI: 10.1371/journal.pone.0303333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/23/2024] [Indexed: 05/19/2024] Open
Abstract
Insulin resistance is a common pathophysiology in patients with type 2 diabetes mellitus, cardiovascular disease, and non-alcoholic fatty liver disease. Thus, screening for the risk of insulin resistance is important to prevent disease progression. We evaluated the alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio to predict insulin resistance in the general population, regardless of comorbidities. Datasets from the 2015, 2019, and 2020 Korea National Health and Nutrition Examination Surveys were used, and the following four indices were implemented to indicate insulin resistance: fasting serum glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and β-cell function. We analyzed the degree of association between the liver enzyme profile and insulin resistance indices using Pearson's correlation coefficient and determined the associations using linear or logistic regression analysis. Accordingly, ALT levels in both sexes were positively and consistently correlated with the four aforementioned insulin resistance indices in stratification analyses based on diabetes, dyslipidemia, alcohol consumption, and obesity status. In multivariate linear regression, when comparing with ALT levels, the ALT/AST ratio exhibited superior predictive performance for fasting serum glucose and HOMA-β in Korean men and improved outcomes for all insulin resistance indices in Korean women. In this analysis that included a large community-based population, the ALT/AST ratio was a more useful predictive marker than the HOMA-IR. Regarding the predicted presence or absence of insulin resistance, the ALT/AST ratio could better predict HOMA-IR than the ALT level alone in Koreans. A simple, precise marker that represents the ALT/AST ratio could be a practical method to screen for insulin resistance in the general population, regardless of diabetes mellitus, alcohol intake, and sex.
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Affiliation(s)
- Seul Ki Han
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Myung Jae Seo
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Taesic Lee
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Division of Data Mining and Computational Biology, Institute of Global Health Care and Development, Wonju, Korea
| | - Moon Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
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Son DH, Han JH, Lee JH. Neck Circumference as a Predictor of Insulin Resistance in People with Non-alcoholic Fatty Liver Disease. J Obes Metab Syndr 2023; 32:214-223. [PMID: 37649143 PMCID: PMC10583771 DOI: 10.7570/jomes22066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/17/2023] [Accepted: 05/21/2023] [Indexed: 09/01/2023] Open
Abstract
Background Insulin resistance is common in individuals with non-alcoholic fatty liver disease (NAFLD). Because insulin resistance is a predictive factor for advanced liver diseases in people with NAFLD, efforts have been made to predict it through anthropometric variables. Recently, neck circumference (NC) has been regarded as a reliable alternative marker for metabolic disorders. This study verified the association between NC and insulin resistance in patients with NAFLD. Methods We analyzed data from 847 people with NAFLD who participated in the 2019 Korean National Health and Nutrition Examination Survey. NAFLD was defined by a hepatic steatosis index score of ≥36 points, and insulin resistance was defined by a homeostatic model assessment of insulin resistance score of ≥2.5 points. Participants were divided according to sex-specific NC tertiles (T1, lowest; T2, middle; T3, highest). Results In the analysis of the area under the receiver operating characteristic curve (AUC), NC displayed a greater predictive power than body mass index (BMI) for insulin resistance in women (AUC of NC=0.625 vs. AUC of BMI=0.573, P=0.035). NC and the odds ratio (OR) for insulin resistance showed a cubic relationship in both men and women. In the weighted multiple logistic regression analysis, the ORs with 95% confidence intervals for insulin resistance in people with NAFLD in T2 and T3 compared to the reference tertile (T1) were 1.06 (0.47-2.41) and 1.13 (0.41-3.11), respectively, in men and 1.12 (0.64-1.97) and 2.54 (1.19-5.39), respectively, in women, after adjusting for confounding factors. Conclusion NC was positively correlated with insulin resistance in women with NAFLD.
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Affiliation(s)
- Da-Hye Son
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Hye Han
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea
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Lee JH, Jeon S, Lee HS, Kwon YJ. Association between waist circumference trajectories and incident non-alcoholic fatty liver disease. Obes Res Clin Pract 2023; 17:398-404. [PMID: 37704496 DOI: 10.1016/j.orcp.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/20/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE Waist circumference (WC) is linked to non-alcoholic fatty liver disease (NAFLD) incidence. However, the impact of longitudinal WC changes on NAFLD remains unclear. We investigated WC trajectories and NAFLD incidence in a large population-based cohort. METHODS We analyzed data from 2666 participants without NAFLD, who underwent biennial check-ups for 16 years, divided into a 6-year exposure period and a 10-year event accrual period. Participants were classified into increasing and decreasing WC trajectory groups during the median 5.9-year exposure period by group-based trajectory modeling. Multiple Cox proportional hazard regression analysis estimated the hazard ratio (HR) and 95 % confidence interval (CI) for incident NAFLD. RESULTS During the median 9.7-year event accrual period, 799 participants developed NAFLD. The increasing WC trajectory group had a higher NAFLD risk than the decreasing group, with an HR of 1.20 (95 % CI: 1.02-1.42). After adjusting for confounders, the adjusted-HR was 1.28 (95 % CI: 1.07-1.53). Subgroup analyses revealed significant findings for groups, regardless of abdominal obesity status. CONCLUSION An increasing WC trend was associated with a higher NAFLD risk, independent of abdominal obesity status. Monitoring WC changes may facilitate early detection of NAFLD risk groups and promote lifestyle modifications to prevent NAFLD onset.
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Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, the Republic of Korea; Department of Medicine, Hanyang University Graduate School of Medicine, Seoul 04763, the Republic of Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 03277, the Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 03277, the Republic of Korea.
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, the Republic of Korea.
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Ismaiel A, Hosiny BE, Ismaiel M, Leucuta DC, Popa SL, Catana CS, Dumitrascu DL. Waist to height ratio in nonalcoholic fatty liver disease - Systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 2023; 47:102160. [PMID: 37321322 DOI: 10.1016/j.clinre.2023.102160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/14/2023] [Accepted: 06/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIMS Current nonalcoholic fatty liver disease (NAFLD) guidelines do not provide any recommendations regarding the waist-to-height ratio (WHtR), a simple obesity metric calculated by dividing waist circumference by height. Therefore, we performed a systematic review and meta-analysis aiming to evaluate WHtR in NAFLD. METHODS We performed a systematic electronic search on PubMed, Embase, and Scopus, identifying observational studies assessing WHtR in NAFLD. QUADAS-2 tool was used to evaluate the quality of included studies. The two main statistical outcomes were the area under the curve (AUC) and the mean difference (MD). RESULTS We included a total of 27 studies in our quantitative and qualitative synthesis, with a total population of 93,536 individuals. WHtR was significantly higher in NAFLD patients compared to controls with an MD of 0.073 (95% CI 0.058 - 0.088). This was also confirmed after conducting a subgroup analysis according to the hepatic steatosis diagnosis method, for ultrasound (MD 0.066 [96% CI 0.051 - 0.081]) and transient elastography (MD 0.074 [96% CI 0.053 - 0.094]). Moreover, NAFLD male patients presented significantly lower WHtR compared to female patients (MD -0.022 [95% CI -0.041 - -0.004]). The AUC of WHtR for predicting NAFLD was 0.815 (95% CI 0.780 - 0.849). CONCLUSIONS WHtR is considerably higher in NAFLD patients compared to controls. Female NAFLD patients present higher WHtR compared to NAFLD male patients. In comparison to other presently suggested scores and markers, the WHtR's accuracy in predicting NAFLD is considered acceptable.
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Affiliation(s)
- Abdulrahman Ismaiel
- 2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Blal El Hosiny
- Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Mohamed Ismaiel
- Cardiothoracic Surgery department, Royal Victoria Hospital, Belfast, United Kingdom
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
| | - Stefan-Lucian Popa
- 2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Cristina Sorina Catana
- Department of Medical Biochemistry, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dan L Dumitrascu
- 2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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Li M, Zhang W, Li X, Liang S, Zhang Y, Mo Y, Rao S, Zhang H, Huang Y, Zhu Y, Zhang Z, Yang W. Metabolic and Risk Profiles of Lean and Non-Lean Hepatic Steatosis among US Adults. Nutrients 2023; 15:2856. [PMID: 37447183 DOI: 10.3390/nu15132856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Hepatic steatosis can occur in lean individuals, while its metabolic and risk profiles remain unclear. We aimed to characterize the clinical and risk profiles of lean and non-lean steatosis. This cross-sectional study included 1610 patients with transient elastography-assessed steatosis. The metabolic and risk profiles were compared. Compared to their non-lean counterparts, lean subjects with steatosis had a lower degree of fibrosis (F0-F1: 91.9% vs. 80.9%), had a lower prevalence of diabetes (27.9% vs. 32.8%), dyslipidemia (54.7% vs. 60.2%) and hypertension (50.0% vs. 51.3%), and had higher levels of high-density lipoprotein cholesterol while lower fasting insulin and homeostatic model assessment for insulin resistance (all p < 0.05). Of the 16 potential risk factors, being Hispanic was associated with higher odds of non-lean steatosis but not with lean steatosis (odds ratio (OR): 2.07 vs. 0.93), while excessive alcohol consumption had a different trend in the ratio (OR: 1.47 vs.6.65). Higher waist-to-hip ratio (OR: 7.48 vs. 2.45), and higher waist circumference (OR: 1.14 vs. 1.07) showed a stronger positive association with lean steatosis than with non-lean steatosis (all Pheterogeneity < 0.05). Although lean individuals with steatosis presented a healthier metabolic profile, both lean and non-lean steatosis had a significant proportion of metabolic derangements. In addition, the etiological heterogeneity between lean and non-lean steatosis may exist.
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Affiliation(s)
- Meiling Li
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei 230032, China
| | - Weiping Zhang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xiude Li
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Shaoxian Liang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yaozong Zhang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yufeng Mo
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Songxian Rao
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Honghua Zhang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yong Huang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yu Zhu
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Zhuang Zhang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Wanshui Yang
- Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei 230032, China
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Jiang Y, Yue R, Liu G, Liu J, Peng B, Yang M, Zhao L, Li Z. Garlic ( Allium sativum L.) in diabetes and its complications: Recent advances in mechanisms of action. Crit Rev Food Sci Nutr 2022; 64:5290-5340. [PMID: 36503329 DOI: 10.1080/10408398.2022.2153793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia and impaired islet secretion that places a heavy burden on the global health care system due to its high incidence rate, long disease course and many complications. Fortunately, garlic (Allium sativum L.), a well-known medicinal plant and functional food without the toxicity and side effects of conventional drugs, has shown positive effects in the treatment of diabetes and its complications. With interdisciplinary development and in-depth exploration, we offer a clear and comprehensive summary of the research from the past ten years, focusing on the mechanisms and development processes of garlic in the treatment of diabetes and its complications, aiming to provide a new perspective for the treatment of diabetes and promote the efficient development of this field.
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Affiliation(s)
- Yayi Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guojie Liu
- School of Chemical Engineering, Sichuan University, Chengdu, China
| | - Jun Liu
- People's Hospital of NanJiang, Bazhong, China
| | - Bo Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maoyi Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lianxue Zhao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zihan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Kuang M, Sheng G, Hu C, Lu S, Peng N, Zou Y. The value of combining the simple anthropometric obesity parameters, Body Mass Index (BMI) and a Body Shape Index (ABSI), to assess the risk of non-alcoholic fatty liver disease. Lipids Health Dis 2022; 21:104. [PMID: 36266655 PMCID: PMC9585710 DOI: 10.1186/s12944-022-01717-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background Body mass index (BMI) and A Body Shape Index (ABSI) are current independent risk factors for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to explore the value of combining these two most common obesity indexes in identifying NAFLD. Methods The subjects in this study were 14,251 individuals from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA) cohort who underwent routine health examination. We integrated BMI with WC and with ABSI to construct 6 combined obesity indicators—obesity phenotypes, the combined anthropometric risk index (ARI) for BMI and ABSI, optimal proportional combination OBMI+WC and OBMI+ABSI, and multiplicative combination BMI*WC and BMI*ABSI. Several multivariable logistic regression models were established to evaluate the relationship between BMI, WC, ABSI, and the above six combined indicators and NAFLD; receiver operating characteristic (ROC) curves were drawn to compare the ability of each obesity indicator to identify NAFLD. Results A total of 2,507 (17.59%) subjects were diagnosed with NAFLD. BMI, WC, ABSI, and all other combined obesity indicators were significantly and positively associated with NAFLD in the current study, with BMI*WC having the strongest correlation with NAFLD in female subjects (OR per SD increase: 3.13) and BMI*ABSI having the strongest correlation in male subjects (OR per SD increase: 2.97). ROC analysis showed that ARI and OBMI+ABSI had the best diagnostic performance in both sexes, followed by BMI*WC (area under the curve: female 0.8912; male 0.8270). After further age stratification, it was found that ARI and multiplicative indicators (BMI*WC, BMI*ABSI) and optimal proportional combination indicators (OBMI+WC, OBMI+ABSI) significantly improved the NAFLD risk identification ability of the basic anthropometric parameters in middle-aged females and young and middle-aged males. Conclusion In the general population, BMI combined with ABSI best identified obesity-related NAFLD risk and was significantly better than BMI or WC, or ABSI. We find that ARI and the multiplicative combined indicators BMI*WC and BMI*ABSI further improved risk prediction and may be proposed for possible use in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01717-8.
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Affiliation(s)
- Maobin Kuang
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Chong Hu
- Department of Gastroenterology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Song Lu
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Nan Peng
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China.
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11
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Xue W, Zhang J, Zhu Y, Huang W. Identify Functional lncRNAs in Nonalcoholic Fatty Liver Disease by Constructing a ceRNA Network. ACS OMEGA 2022; 7:22522-22530. [PMID: 35811919 PMCID: PMC9260751 DOI: 10.1021/acsomega.2c01801] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Aim: To identify functional long noncoding RNAs (lncRNAs) by constructing a NAFLD-related lncRNA-miRNA-mRNA network (NLMMN) based on the hypothesis that lncRNAs, as competitive endogenous RNAs (ceRNAs), are able to regulate mRNA functions by competitive binding to shared miRNAs. Methods: The "Limma R package" was used to identify differentially expressed lncRNAs and mRNAs (DElncRNAs and DEmRNAs). The "miRcode online tool" was used to predict the potential interactions between DElncRNAs or DEmRNAs using Perl, and "multiMiR R package" was used to predict the potential interactions between DElncRNAs and miRNAs. The NLMMN was viewed by Cytoscape. The DEmRNAs were further analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to identify functional lncRNAs in human liver tissue and FFAs-induced fat-overloading HepG2 cells. The role of functional lncRNA was explored in the HepG2 cell line. Results: A total of 336 DElncRNAs (154 upregulated and 182 downregulated, |log 2 (fold change) |>0.655 and P < 0.05) and 399 DEmRNAs (152 upregulated and 247 downregulated, |log 2 (fold change) |>0.608 and P < 0.05) were identified. A total of 142 DElncRNA-miRNA interaction pairs and 643 miRNA-DEmRNA interaction pairs were retained to construct the NLMMN, which contained 19 lncRNAs, 47 miRNAs, and 228 mRNAs. The results of GO and KEGG enrichment analyses were related to an extracellular matrix (ECM). Two upregulated lncRNAs (LINC00240 and RBMS3-AS3) and one downregulated lncRNA (ALG9-IT1) were identified by qRT-PCR in liver tissues. But only LINC00240 was significantly upregulated in fat-overloading HepG2 cells. Overexpression of LINC00240 did not affect lipid accumulation but increased the reactive oxygen species (ROS) content in HepG2 cells. Conclusion: LINC00240, RBMS3-AS3, and ALG9-IT1 might be novel functional lncRNAs that attenuate liver fibrosis in NAFLD by influencing the ECM through the ceRNA network. Among them, LINC00240 might have a key role.
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Affiliation(s)
- Wei Xue
- Chongqing
Key Laboratory of Infectious Diseases and Parasitic Diseases, Department
of Infectious Diseases, The First Affiliated
Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Jia Zhang
- Chongqing
Key Laboratory of Infectious Diseases and Parasitic Diseases, Department
of Infectious Diseases, The First Affiliated
Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Yali Zhu
- Chongqing
Key Laboratory of Infectious Diseases and Parasitic Diseases, Department
of Infectious Diseases, The First Affiliated
Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China
| | - Wenxiang Huang
- Department
of Geriatrics, The First Affiliated Hospital
of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China
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12
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Barreto BFDM, Punaro GR, Elias MC, Parise ER. IS HOMEOSTASIS MODEL ASSESSMENT FOR INSULIN RESISTANCE >2.5 A DISTINGUISHED CRITERIA FOR METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE IDENTIFICATION? ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:402-407. [PMID: 36102439 DOI: 10.1590/s0004-2803.202203000-72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Insulin resistance (IR), assessed by different criteria, is an important factor in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). More recently with the characterization of this metabolic dysfunction-associated fatty liver disease (MAFLD), one of the proposed criteria for this diagnosis has been the determination of the homeostasis model assessment-insulin resistance (HOMA-IR). OBJECTIVE The purpose of this study was to evaluate the relationship of HOMA-IR>2.5 with clinical, metabolic, biochemical and histological data obtained in non-diabetic patients diagnosed with NAFLD by liver biopsy. METHODS Cross-sectional, retrospective study was carried out with data from 174 adult individuals of both genders with non-diabetics NAFLD, without obvious signs of portal hypertension. The body mass index (BMI) was classified according to the World Health Organization (1998), and the metabolic syndrome by the criteria of NCEP-ATP-III. Biochemical tests were evaluated using an automated method and insulinemia through immunofluorometric assay. Histological findings were classified according to Kleiner et al. (2005). RESULTS The mean age of the studied population was 53.6±11.2 years, with 60.3% being female. The average BMI was 30.3 kg/m2 and 75.9% of the patients had increased waist circumference. Among evaluated metabolic parameters, there was a higher prevalence of metabolic syndrome (MS) in patients with HOMA-IR>2.5, with no statistical difference in relation to BMI between studied groups. Values of liver enzymes and serum ferritin were significantly higher in patients with this marker of IR, who had a higher prevalence of non-alcoholic steatohepatitis (NASH) and advanced liver fibrosis. In the multivariate analysis, the clinical diagnosis of MS, hyperferritinemia and the presence of NASH in the liver biopsy were the factors independently associated with the presence of altered HOMA-IR. CONCLUSION HOMA-IR values >2.5 identify patients with NAFLD with distinct clinical and metabolic characteristics and with a greater potential for disease progression, which validates this parameter in the identification of patients with MAFLD.
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Affiliation(s)
| | - Giovana Rita Punaro
- Universidade Federal de São Paulo, Departamento de Medicina-Nefrologia, São Paulo, SP, Brasil
| | - Maria Cristina Elias
- Universidade Federal de São Paulo, Departamento de Medicina-Gastroenterologia, São Paulo, SP, Brasil
| | - Edison Roberto Parise
- Universidade Federal de São Paulo, Departamento de Medicina-Gastroenterologia, São Paulo, SP, Brasil
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13
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Almeida NS, Rocha R, Daltro C, Souza CAD, Silva RLPD, Sarno MAC, Cotrim HP. Anthropometric clinical indicators of visceral adiposity as predictors of nonalcoholic fatty liver disease. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2021; 67:1544-1549. [PMID: 34909876 DOI: 10.1590/1806-9282.20210316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aims to evaluate the role of anthropometric clinical indicators of visceral adiposity as predictors of NAFLD, identifying the cutoff points based on gender. METHODS This was a cross-sectional study conducted in patients with or without NAFLD. Waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), Conicity Index (C Index), and lipid accumulation product (LAP) were evaluated. RESULTS A total of 107 individuals were evaluated, of which 46.7% were diagnosed with NAFLD. Individuals with NAFLD presented higher values of WC, BMI, C Index, LAP, and WHtR when compared with those without NAFLD (p<0.05). For the total sample, the indicators WC, BMI, WHtR, LAP, and C Index had an area under the receiver operator characteristic curve (AUC) above 0.87, with no difference in the prediction of NAFLD in both sexes. WHtR (AUC=0.934) was the indicator of visceral adiposity with the best discriminatory power for NAFLD, followed by LAP (0.919), WC (0.912), C Index (0.907), and BMI (0.877). CONCLUSIONS The anthropometric clinical indicators of visceral adiposity showed high performance, especially the WHtR indicator, as NAFLD predictors.
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Affiliation(s)
- Naiade Silveira Almeida
- Universidade Federal da Bahia, Escola de Nutrição, Departamento de Ciências da Nutrição - Salvador (BA), Brazil
| | - Raquel Rocha
- Universidade Federal da Bahia, Escola de Nutrição, Departamento de Ciências da Nutrição - Salvador (BA), Brazil
| | - Carla Daltro
- Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde -Salvador (BA), Brazil
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14
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Cai J, Lin C, Lai S, Liu Y, Liang M, Qin Y, Liang X, Tan A, Gao Y, Lu Z, Wu C, Huang S, Yang X, Zhang H, Kuang J, Mo Z. Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population. Lipids Health Dis 2021; 20:145. [PMID: 34706716 PMCID: PMC8549212 DOI: 10.1186/s12944-021-01568-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Therefore anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. This study intended to validate and compare the MAFLD predictive and diagnostic capability of eight anthropometric indicators. Methods The study involved a population-based retrospective cross-sectional design. The Fangchenggang area male health and examination survey (FAMHES) was used to collect data of eight anthropometric indicators, involving body mass index (BMI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and abdominal volume index (AVI). Receiver operating characteristics (ROC) curves and the respective areas under the curves (AUCs) were utilized to compare the diagnostic capacity of each indicator for MAFLD and to determine the optimal cutoff points. Binary logistic regression analysis was applied to identify the odds ratios (OR) with 95% confidence intervals (95% CI) for all anthropometric indicators and MAFLD. The Spearman rank correlation coefficients of anthropometric indicators, sex hormones, and MAFLD were also calculated. Results All selected anthropometric indicators were significantly associated with MAFLD (P < 0.001), with an AUC above 0.79. LAP had the highest AUC [0.868 (95% CI, 0.853–0.883)], followed by WHtR [0.863 (95% CI, 0.848–0.879)] and AVI [0.859 (95% CI, 0.843–0.874)]. The cutoff values for WHtR, LAP and AVI were 0.49, 24.29, and 13.61, respectively. WHtR [OR 22.181 (95% CI, 16.216–30.340)] had the strongest association with MAFLD, regardless of potential confounders. Among all the anthropometric indicators, the strongest association was seen between LAP and sex hormones. Conclusion All anthropometric indicators were associated with MAFLD. WHtR was identified as the strongest predictor of MAFLD in young Chinese males, followed by LAP and AVI. The strongest association was found between LAP and sex hormones. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01568-9.
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Affiliation(s)
- Jinwei Cai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Cuiting Lin
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yingshan Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Min Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xinghuan Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Aihua Tan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yong Gao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zheng Lu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Chunlei Wu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shengzhu Huang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian Kuang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China
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15
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Schwenger KJP, Kiu A, AlAli M, Alhanaee A, Fischer SE, Allard JP. Comparison of bioelectrical impedance analysis, mass index, and waist circumference in assessing risk for non-alcoholic steatohepatitis. Nutrition 2021; 93:111491. [PMID: 34739937 DOI: 10.1016/j.nut.2021.111491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/23/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease is a leading cause of liver disease worldwide and includes nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Because NASH is associated with obesity severity, routine evaluation of obesity/body fat in clinical settings may help detect patients at risk. The aim of this study was to determine whether assessing body fat by bioelectrical impedance analysis (BIA) is superior to body mass index (BMI) and waist circumference (WC) in assessing the risk for NASH. METHODS In this cross-sectional study, patients were recruited and gave consent from a local hospital. All had a liver biopsy. Measurements before the biopsy included BMI, WC, and BIA. BIA was used to measure percentage body fat and fat mass (kg). Based on histology, patients were grouped into one of three categories: simple steatosis (SS), NASH, or normal liver (NL). RESULTS Of the 139 participants who participated, 39 were classified as SS, 53 as NASH, and 47 as NL. Regardless of sex, patients with NASH had significantly higher BMI, WC, percentage body fat and fat mass than those with NL or SS. These four parameters were significantly positively correlated with liver histology measurements. In all patients, when controlling for sex and age we found that BMI, WC, and BIA were equal at predicting the presence of NASH (P = 0.0571). CONCLUSION All three methods, BIA, BMI, and WC, were comparable in assessing the risk for NASH. For practical purpose in clinical settings, using BMI is acceptable.
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Affiliation(s)
| | - Alexander Kiu
- Toronto General Hospital, University Health Network, Toronto, Canada
| | - Maryam AlAli
- Toronto General Hospital, University Health Network, Toronto, Canada
| | - Amnah Alhanaee
- Tawam Hospital, Abu Dhabi Health Authority, Abu Dhabi, United Arab Emirates
| | - Sandra E Fischer
- Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Johane P Allard
- Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
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16
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Chao HC, Lin HY. Comparison of Body Mass Index and Fat Indices in Predicting the Severity of Nonalcoholic Fatty Liver Disease Among Children Who Are Overweight and Obese. Front Pediatr 2021; 9:724426. [PMID: 34513769 PMCID: PMC8432615 DOI: 10.3389/fped.2021.724426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Information of the relationships between body mass parameters and the severity of fatty liver is deficient in pediatric nonalcoholic fatty liver disease (NAFLD). Methods: The relationships between body mass parameters (waist circumference [WC], body mass index [BMI], and abdominal subcutaneous fat thickness [ASFT]) and the severity of fatty liver were prospectively evaluated in pediatric patients who are overweight or obese, suffering from NAFLD. Ultrasonography was performed to assess fatty liver and its severity on a three-grade scale (low-grade fatty liver [LGFL], grade 1 or 2; high-grade fatty liver [HGFL], grade 3). Results: A total of 110 subjects (55 LGFL and 55 HGFL) aged 6.2-17.9 years were included. The WC, BMI, and ASFT values were significantly higher in the HGFL group compared to those in the LGFL group (p = 0.00004, 0.01, and 0.04, respectively). WC had the greatest power to predict HGFL under receiver-operating characteristic curve analyses and was positively correlated with the severity of fatty liver in subjects aged 6-12-year old and 13-17-year old (p = 0.007, and 0.0039, respectively). ASFT showed a positive correlation with the severity of fatty liver in subjects aged 13-17-year old (p = 0.04). Conclusions: WC, BMI, and ASFT are predictive of severe NAFLD among children who are overweight and obese; particularly, WC has the most predictive accuracy. Among the parameters, WC and ASFT are predictive in specific age groups.
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Affiliation(s)
- Hsun-Chin Chao
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Hsin-Yeh Lin
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
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17
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Golabi P, Paik JM, Arshad T, Younossi Y, Mishra A, Younossi ZM. Mortality of NAFLD According to the Body Composition and Presence of Metabolic Abnormalities. Hepatol Commun 2020; 4:1136-1148. [PMID: 32766474 PMCID: PMC7395070 DOI: 10.1002/hep4.1534] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 12/24/2022] Open
Abstract
Although nonalcoholic fatty liver disease (NAFLD) is associated with obesity, it can also occur in lean and metabolically normal individuals. Our aim was to determine the effect of different combinations of abdominal adiposity and overall adiposity on the mortality of NAFLD. The Third National Health and Nutrition Examination Survey with mortality data from the National Death Index were used. NAFLD was defined as steatosis without other liver diseases. Body composition was categorized according to waist circumference (WC) and body mass index (BMI). Obesity pattern was defined according to BMI (lean, overweight, and obese) and WC (normal and obese) using accepted definitions. The “metabolically abnormal” group had visceral obesity, insulin resistance, type 2 diabetes, hypertension, or hyperlipidemia. Of the 9,341 study individuals (47.9% male; 76.8% white), NAFLD was present in 3,140 (33.6%), of whom 0.6% had lean BMI and normal WC, and 1.7% had lean BMI and obese WC. The prevalence of metabolically normal NAFLD was 3.26% (95% confidence interval [CI]: 2.62%‐3.90%), with most of these subjects having lean BMI (79.2%). During an average follow‐up of 22.4 years, 24.1% of the subjects died from all causes. Among these deceased individuals, 41.7% had NAFLD at baseline. Causes of death were cardiovascular disease (24.8%), cancer‐related (24.3%), type 2 diabetes–related (4.4%), and liver‐related (1.7%). Individuals with NAFLD who were lean by BMI but obese by WC had higher risk of all‐cause mortality. Individuals with NAFLD with normal BMI but obese WC had a higher risk of cardiovascular mortality (hazard ratio 2.63 [95% CI: 1.15‐6.01]) as compared with overweight (by BMI) NAFLD with normal WC. Conclusion: The risk of mortality in NAFLD can be affected by the presence of visceral obesity, especially in the lean BMI group. These data have important management implications for patients with NAFLD.
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Affiliation(s)
- Pegah Golabi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System Inova Health System Falls Church VA
| | - James M Paik
- Betty and Guy Beatty Center for Integrated Research, Inova Health System Inova Health System Falls Church VA
| | - Tamoore Arshad
- Center For Liver Diseases Department of Medicine Inova Fairfax Medical Campus Falls Church VA
| | | | - Alita Mishra
- Center For Liver Diseases Department of Medicine Inova Fairfax Medical Campus Falls Church VA
| | - Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System Inova Health System Falls Church VA.,Center For Liver Diseases Department of Medicine Inova Fairfax Medical Campus Falls Church VA
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18
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Jung YW, Kim M, Kim BK, Park JY, Kim DY, Ahn SH, Han KH, Kim SU. Influence of Besifovir Dipivoxil Maleate Combined with L-Carnitine on Hepatic Steatosis in Patients with Chronic Hepatitis B. J Korean Med Sci 2020; 35:e104. [PMID: 32356416 PMCID: PMC7200179 DOI: 10.3346/jkms.2020.35.e104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Besifovir dipivoxil maleate (BSV) with L-carnitine is the first-line antiviral agent for chronic hepatitis B (CHB) infection. We investigated whether BSV combined with L-carnitine improves hepatic steatosis (HS). METHODS Treatment-naïve patients with CHB who were initiated on antiviral therapy (AVT) were enrolled. The magnitude of HS was assessed using hepatic steatosis index (HSI), and HS improvement was defined as a ≥ 10% reduction in the HSI score from the baseline. RESULTS The mean age of the study patients was 56 years with a male predominance (n = 178, 64.7%). The mean body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count were 23.5 kg/m², 49.6 IU/L, 49.0 IU/L, and 191.3 × 10⁹/L, respectively. The mean HSI and fibrosis (FIB)-4 index were 32.6 and 0.5, respectively. After 6 months of AVT, platelet count (mean, 191.3→167.0 × 10⁹/L), fasting glucose (mean, 113.1→105.9 mg/dL), AST (mean, 49.6→28.0 IU/L), ALT (mean, 49.0→33.9 IU/L), and total cholesterol (mean, 170.0→162.1 mg/dL) levels significantly decreased (all P < 0.05). In the BSV group, AST (mean, 95.2→30.2 IU/L) and ALT (mean, 81.1→31.1 IU/L) levels significantly reduced (all P < 0.05), whereas HSI and FIB-4 index were maintained (all P > 0.05). In the univariate analysis, age, BMI, diabetes, cirrhosis, fasting glucose level, and ALT were significantly associated with HS improvement (all P < 0.05). CONCLUSION BSV with L-carnitine did not show any improvement of HS in patients with CHB. Further prospective randomized controlled studies are needed to validate the potential beneficial effects of BSV with L-carnitine in CHB infection.
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Affiliation(s)
- Yeon Woo Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Moonhyun Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Kwang Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Liver Center, Severance Hospital, Seoul, Korea.
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王 珊, 张 健, 张 卫, 汪 海, 侯 婧, 张 瑞, 刘 红, 吴 寿. [Predictive value of body mass index combined with waist circumference for new-onset nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:1293-1297. [PMID: 31852647 PMCID: PMC6926090 DOI: 10.12122/j.issn.1673-4254.2019.11.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the predictive value of body mass index (BMI) combined with waist circumference (WC) for new-onset nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS This community-based prospective cohort study was conducted among 3501 T2DM patients without NAFLD recruited from the staff of Kailuan Company, who underwent routine physical examination in the year 2006 and 2007, and a total of 2920 subjects were included in the final analysis. According to the baseline BMI and WC, the subjects were divided into group A (with normal BMI and WC), group B (with normal BMI but elevated WC), group C (with elevated BMI but a normal WC) and group D (with elevated BMI and WC). The subjects in the 4 groups were followed for the occurrence of NAFLD by reviewing their reports of physical examinations during the periods of 2008-2009, 2010-2011, 2012-2013, 2014-2015 and 2016-2017. The cumulative incidence of NAFLD was compared across the 4 groups and Cox regression analysis was used to test the correlation of BMI and WC with new onset of NAFLD. RESULTS The cumulative incidence of NAFLD increased progressively in the 4 groups (50%, 66%, 68% and 77%, respectively). Cox regression analysis showed that compared with group A, groups B, C and D had increased risks of NAFLD after adjusting for age, gender and other risk factors, with HR values of 1.62, 1.98 and 2.47, respectively. CONCLUSIONS Elevated BMI and WC are both independent risk factors for NAFLD in type 2 diabetic patients, and the combination of BMI and WC has a greater predictive value for NAFLD than either of them alone.
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Affiliation(s)
- 珊 王
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 健 张
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 卫欢 张
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 海涛 汪
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 婧悦 侯
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 瑞秀 张
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
| | - 红芬 刘
- 石家庄市第一医院，河北 石家庄 050000First Hospital of Shijiazhuang, Shijiazhuang 050000, China
| | - 寿岭 吴
- 开滦总医院，河北 唐山 063000Kailuan General Hospital, Tangshan 063000, China
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20
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Alam S, Anam K, Islam S, Mustafa G, Mamun AA, Ahmad N. Clinical, anthropometric, biochemical and histological character of nonalcoholic fatty liver disease without Insulin Resistance. J Clin Exp Hepatol 2019; 9:176-181. [PMID: 31024199 PMCID: PMC6477145 DOI: 10.1016/j.jceh.2018.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 06/04/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Nonalcoholic Fatty Liver Disease (NAFLD) is thought to be a hepatic manifestation of Metabolic Syndrome (MS) or Insulin Resistance (IR). The aim of the study was to explore the clinical, anthropometric, metabolic, biochemical and histological profile of NAFLD patients without IR by comparing it with NAFLD with IR. METHODS Total 851 patients with sonographic evidence of fatty liver were included. These patients underwent clinical, anthropometric, biochemical and histological evaluation. IR was calculated using the homeostatic model assessment. Liver biopsy done in 285 patients who consented for the procedure and who had MS or raised ALT. RESULTS Among 851 NAFLD patients, 561(65.9%) patients were without IR and 290 (34.1%) patients were with IR. The proportion of male sex [230 (41.0%) vs. 89 (30.7%); P = 0.046] were higher but diabetes [19.10% vs. 39.0%; P = 0.000] and MS were [58.80%vs. 78.10%; P = 0.014] significantly lower in non IR group. Body Mass Index (BMI) kg/m2 and Waist Circumference (WC) in cm were also lower in non IR group: [26.6 ± 3.5 vs. 27.9 ± 4.3; P = 0.002] and [93.3 ± 8.4 vs. 95.9 ± 8.4; P = .003]. Lipid profile, ALT, AST and ALP were not differed between the groups. Histopathology reports revealed that lobular inflammation, ballooning and fibrosis were similar in two groups, only steatosis score was higher in IR group [2.0 ± 0.7 vs. 1.8 ± 0.8; P = 0.007]. CONCLUSION There are significant proportion of NAFLD patients without IR in Bangladesh. NAFLD patients without IR predominantly male, had lower BMI, WC, MS and diabetes. Histologically NAFLD without IR equally severe with ballooning, lobular inflammation and fibrosis except steatosis. Insulin resistance is the principal but not the sole factor for NAFLD in our population.
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Affiliation(s)
- Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh
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Almeida NS, Rocha R, Cotrim HP, Daltro C. Anthropometric indicators of visceral adiposity as predictors of non-alcoholic fatty liver disease: A review. World J Hepatol 2018; 10:695-701. [PMID: 30386462 PMCID: PMC6206145 DOI: 10.4254/wjh.v10.i10.695] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/01/2018] [Accepted: 06/08/2018] [Indexed: 02/06/2023] Open
Abstract
The objective was to critically analyze studies that evaluated the predictive capacity of indicators of visceral adiposity in non-alcoholic fatty liver disease (NAFLD). The bibliographic research was carried out using the electronic database PubMed, LILACS and SciELO, references of selected articles. Although we found few studies, they have already used several indicators of visceral adiposity as waist circumference, waist-to-hip ratio, waist-to-height ratio, Lipid accumulation product, Body Shape Index, Body Roundness Index and most them were good predictors of NAFLD. Thus, the anthropometric indicators may contribute for the diagnosis of NAFLD in a simple, low-cost and non-invasive way, allowing early therapeutic measures to prevent the evolution to non-alcoholic steatohepatitis.
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Affiliation(s)
- Naiade Silveira Almeida
- Department of Sciences of Nutrition, School of Nutrition, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
| | - Raquel Rocha
- Department of Sciences of Nutrition, School of Nutrition, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil.
| | - Helma Pinchemel Cotrim
- Faculty of Medicine of Bahia, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
| | - Carla Daltro
- Department of Sciences of Nutrition, School of Nutrition, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
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22
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Jorge ASB, Andrade JMO, Paraíso AF, Jorge GCB, Silveira CM, de Souza LR, Santos EP, Guimaraes ALS, Santos SHS, De-Paula AMB. Body mass index and the visceral adipose tissue expression of IL-6 and TNF-alpha are associated with the morphological severity of non-alcoholic fatty liver disease in individuals with class III obesity. Obes Res Clin Pract 2018; 12:1-8. [DOI: 10.1016/j.orcp.2016.03.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/21/2016] [Accepted: 03/22/2016] [Indexed: 12/14/2022]
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Clemente APG, Netto BDM, de Carvalho-Ferreira JP, da Silveira Campos RM, de Piano Ganen A, Tock L, de Mello MT, Dâmaso AR. Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents. REVISTA PAULISTA DE PEDIATRIA (ENGLISH EDITION) 2016. [PMID: 26830602 PMCID: PMC4795721 DOI: 10.1016/j.rppede.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: To assess the relationship between the degree of waist circumference (WC) and
nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders,
analyzed according to quartiles of WC. Methods: Cross-sectional study that involved 247 obese adolescents aged 12–19 years. Mean
values of the nutritional parameters and serum analyses were compared with the
groups using the independent t-test. Pearson correlation
coefficient was used to determine the relationship of the parameters studied.
Chi-square test for trend was used to determine the relationship between the
prevalence of the NAFLD and WC quartile by gender. Results: NAFLD were presented in 60% of the study participants. Obese adolescents in the
3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared
with that in the 1st quartile in both genders. The NAFLD patients had
significantly higher values for body weight, BMI (body mass index), BAZ-score
(BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin
resistance index (HOMA-IR), aspartate aminotransferase and alanine
aminotransferase, when compared with non-NAFLD obese adolescents. Conclusions: In conclusion, the results presented here suggest that an increase in WC can
reliably predict the risk of NAFLD in obese adolescents. This is a low cost and
easy-to-use tool that can help in screening in adolescents.
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Affiliation(s)
| | - Bárbara Dal Molin Netto
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | | | | | - Aline de Piano Ganen
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Lian Tock
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Marco Túlio de Mello
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Ana Raimunda Dâmaso
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
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[Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents]. REVISTA PAULISTA DE PEDIATRIA 2015; 34:47-55. [PMID: 26830602 DOI: 10.1016/j.rpped.2015.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/20/2015] [Accepted: 05/21/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. METHODS Cross-sectional study that involved 247 obese adolescents aged 12-19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. RESULTS NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. CONCLUSIONS The results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.
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Wang S, Tong B, Zhang HL, Jiang XZ, Zhang J, Duan HL, Wu SL. Relationship between waist circumference level and new onset of non-alcoholic fatty liver disease. Shijie Huaren Xiaohua Zazhi 2015; 23:3219-3225. [DOI: 10.11569/wcjd.v23.i20.3219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the relationship between different waist circumference (WC) levels and new onset of non-alcoholic fatty liver disease (NAFLD).
METHODS: A total of 55358 subjects without NAFLD were initially recruited from people who underwent health examination between 2006 and 2007 for this community-based prospective cohort study, and 36978 subjects were finally included in the analysis. According to the baseline WC measurement and its quartile, the subjects were divided into four groups. The incidence of NAFLD in 2012-2013 was compared in the four groups, and multiple Logistic regression analysis was used to test the relationship between different WC levels and new onset of NAFLD.
RESULTS: Along with increasing WC in the four quartile groups, the incidence of NAFLD progressively increased, being13.5%, 26.0%, 31.6% and 38.4%, respectively, of the total population (13.4%, 24.7%, 30.3% and 38.9% in males, and 13.6%, 28.8%, 36.5% and 36.0% in females). Multiple Logistic regression analysis showed that compared with the first quartile group, the second, third, and forth quartile groups had increased risk of NAFLD after adjusting age, gender and other risk factors, with the OR values being 1.72, 1.91 and 2.04, respectively (1.66, 1.87 and 2.19 in males, and 1.60, 1.80 and 1.46 in females).
CONCLUSION: The incidence of NAFLD increases with increasing WC.
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Wang XC, Gusdon AM, Liu H, Qu S. Effects of glucagon-like peptide-1 receptor agonists on non-alcoholic fatty liver disease and inflammation. World J Gastroenterol 2014; 20:14821-14830. [PMID: 25356042 PMCID: PMC4209545 DOI: 10.3748/wjg.v20.i40.14821] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/14/2014] [Accepted: 07/16/2014] [Indexed: 02/06/2023] Open
Abstract
Glucagon-like peptide1 (GLP-1) is secreted from Langerhans cells in response to oral nutrient intake. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a new class of incretin-based anti-diabetic drugs. They function to stimulate insulin secretion while suppressing glucagon secretion. GLP-1-based therapies are now well established in the management of type 2 diabetes mellitus (T2DM), and recent literature has suggested potential applications of these drugs in the treatment of obesity and for protection against cardiovascular and neurological diseases. As we know, along with change in lifestyles, the prevalence of non-alcoholic fatty liver disease (NAFLD) in China is rising more than that of viral hepatitis and alcoholic fatty liver disease, and NAFLD has become the most common chronic liver disease in recent years. Recent studies further suggest that GLP-1RAs can reduce transaminase levels to improve NAFLD by improving blood lipid levels, cutting down the fat content to promote fat redistribution, directly decreasing fatty degeneration of the liver, reducing the degree of liver fibrosis and improving inflammation. This review shows the NAFLD-associated effects of GLP-1RAs in animal models and in patients with T2DM or obesity who are participants in clinical trials.
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