Published online Dec 27, 2018. doi: 10.4254/wjh.v10.i12.924
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
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.
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.
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.
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.
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.
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.
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.