Editorial:Non-Alcoholic Fatty Liver Disease and Obesity:... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTIONS: LIVER

Editorial: Non-Alcoholic Fatty Liver Disease and Obesity: Not All About Body Mass Index

1 Digestive Disease Institute and the Department of Gastroenterology, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence: Mangesh R. Pagadala, MD, Digestive Disease Institute and the Department of Gastroenterology, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA. E-mail: [email protected]

Received 6 August 2012; accepted 8 August 2012

Abstract

Patients with nonalcoholic fatty liver (NAFLD) are typically obese and confounded by the metabolic syndrome. The body mass index (BMI) is often used as a surrogate marker of obesity defined as a BMI >30λkg/m2. However, it is now apparent that it is the distribution of body fat (not total fat) that is associated with NAFLD. Many patients (as many as 25%) with NAFLD are nonobese. This is particularly true in Asians who have a significantly increased risk of cardiovascular disease and diabetes even among those with a normal BMI. It is important for clinicians to be aware that these “metabolically obese” NAFLD patients should be monitored for the metabolic syndrome and its associated adverse outcomes irrespective of their BMI.