Basic Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2018; 10(12): 924-933
Published online Dec 27, 2018. doi: 10.4254/wjh.v10.i12.924
Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique
Duanghathai Pasanta, Montree Tungjai, Sirirat Chancharunee, Warayuth Sajomsang, Suchart Kothan
Duanghathai Pasanta, Montree Tungjai, Suchart Kothan, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
Sirirat Chancharunee, Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Warayuth Sajomsang, National Nanotechnology Center, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani 12120, Thailand
Author contributions: Pasanta D performed the majority of experiments and analyzed the data; Chancharunee S, Tungjai M, Sajomsang W and Kothan S designed and coordinated the research.
Supported by Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand, No. 6593(4)1180.
Institutional review board statement: Approved by the Ethics Committee of the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand (AMSEC-61EX-016).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Suchart Kothan, PhD, Associate Professor, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroros Rd., Sripoom, Chiang Mai 50200, Thailand.
Telephone: +66-53-949213 Fax: +66-53-949207
Received: June 11, 2018
Peer-review started: June 11, 2018
First decision: July 11, 2018
Revised: August 3, 2018
Accepted: August 21, 2018
Article in press: August 21, 2018
Published online: December 27, 2018
Research background

In recent years, the prevalence of non-alcoholic fatty liver disease (NAFLD) in young adults has been increasing at an alarming rate that parallels the global epidemic of weight gain and obesity. NAFLD in young adults is a topic that has received little recognition, yet this age group is the most likely to gain weight and develop obesity from their diet and lifestyle as they are transitioning into adulthood. However, despite the growing public health concern about obesity and NAFLD in young adults, necessary information addressing the effects of obesity and NAFLD pathogenesis in this age group is lacking.

Research motivation

NAFLD is a chronic liver disease that is one of the most common health problems among young adults. We aim to identify the effects of obesity on liver fat content (LFC) and health in this age group. This information is crucial for primary prevention and a better understanding of NAFLD pathogenesis in young adults.

Research objectives

The aim of this present study is to assess the association between LFC by proton magnetic resonance spectroscopy (1H MRS) technique. Using biochemical tests, the total cholesterol (Cho), low-density lipoproteins (LDL), high-density lipoproteins (HDL), fasting plasma glucose (FG), glycosylated hemoglobin (HbA1c), and being overweight/obese (OW/OB) will be determined.

Research methods

A total of 78 healthy subjects in the young adult age group (19-30 years old) participated in this study. A control group was made up of 39 healthy subjects, and the experimental group was made up of 39 overweight or obese (OW/OB) subjects. We performed the liver fat assessment by 1H MRS technique on MRI 1.5 T that was calculated into LFC. Intravenous blood was drawn for biochemical analysis. The test focused on Cho, HDL, VLDL, TG, FG, and HbA1c. The waist circumference (WC) and hip circumference (HC) of each subject was measured, and the waist-to-hip ratio (W/H ratio) was calculated.

Research results

LFC from the OW/OB group (8.1% ± 1.0%) was found to be statistically higher when compared to the control group (2.7% ± 0.2%) (P < 0.001). Additionally, 48.7% of subjects in the OW/OB group had LFC > 5.56%, which is considered to be a cut off point for NAFLD. The OW/OB group reported statistically higher BMI, LFC, WC, HC, FG, Tri, LDL, HbA1c, and statistically lower HDL. Cho was increased in the OW/OB group compared to the control group, but was not statistically significant. The association of BMI and LFC was additionally confirmed by multilinearity regression analysis as a significant independent variable after being adjusted for age and sex (P < 0.001). These findings indicated that BMI is a sensitive marker for LFC in young adults.

Research conclusions

It is proposed that the prevalence of high LFC in the OW/OB group can be the result of weight gain and obesity, and may be a leading pathogenic mechanism of liver fat accumulation in young adults. Moreover, high BMI is a risk factor for metabolic syndrome in young adults. This current study demonstrated the importance of weight control as a tool for the prevention and control of NAFLD and metabolic syndrome in young adults.

Research perspectives

Further study on this topic may require larger groups of subjects, and should also investigate the alteration of LFC and BMI throughout the adult years as a longitudinal study.