Central obesity but not generalised obesity (body mass index) predicts high prevalence of fatty liver (NAFLD), in recently detected untreated, IGT and type 2 diabetes Indian subjects (original) (raw)
Romanian Journal of Internal Medicine
Introduction: NAFLD is strongly associated with metabolic syndrome, and for many years, fatty liver was an exclusive feature of obese patients. The study tries to assess whether the body mass index (BMI) and body circumference is correlated to steatosis, fibrosis, or inflammatory activity of the liver. Methods: 81 patients with recent hepatic biopsy were included in the study and were weighed and measured. The biopsy results were compared to the measurements. Results: The average BMI overall for the whole lot was 30.16. There was a significant difference in BMI across the inflammatory activity categories (p = 0.009): groups with higher necro inflammatory activity tended to have higher BMI values (average values per grade: 0–28, 1–29, 2–33, 3–32, 4–29). There was no significant difference for grades of steatosis (p = 0.871). With regards to waist circumference, the overall average was 90.70cm/35.70in. There was a significant difference across the steatosis categories (p < 0.001): ...
Annals of hepatology
There is sparse literature on the association of adipose tissue with liver histology in patients with nonalcoholic fatty liver disease (NAFLD). To study the correlation of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) with liver histology in Indian patients with NAFLD. A single slice CT scan at the level of L4-L5 vertebrae was done to assess the abdominal VAT and SAT volumes in 21 patients with histological diagnosis of NAFLD. Adult treatment panel III criteria with modified abnormal waist were used to define metabolic syndrome (MS). Histological grading was done according to the NAFLD activity score (NAS). Twenty-one patients with NAFLD [13 males, median age: 35 years, median BMI: 25.97 kg/m(2)] were included prospectively. Even though overweight/obese patients had severe liver disease, there was no difference in the volume of VAT adjusted for BMI between 6 (28.5%) lean and 15 (71.5%) overweight/obese patients. Patients with NASH an...
The Internet Journal of Gastroenterology, 2010
Background. The main cause of non-alcoholic fatty liver disease (NAFLD) is insulin resistance and the one of the most common risk factors for insulin resistance is obesity. The abnormality of lipid metabolism can be seen in NAFLD such as: High level of free fatty acid (FFA) in plasma, formation of reactive oxygen species and high level of lipid peroxidation (malondialdehyde (MDA) and trans-4-hydroxy-2-nonenal).Objective. The aim of the study is to find the risk factors of NAFLD prevalence in obesity with or without diabetes mellitus.Methods. Case control study. The population was taken from general check up patients in Internal Medicine Department, Dr. Sardjito General Hospital Yogyakarta -Indonesia, March 2007 until August 2008. The case group is obesity who suffered diabetes mellitus and the control group is obesity without diabetes mellitus. The Subjects who fulfilled inclusion and exclusion criteria are enrolled in this study. Diagnosis of NAFLD is defined by Liver Ultrasound (Bright Liver appearance). AST, ALT, GGT, cholesterol, triglyceride, fasting glucose, 2 hour post-prandial glucose, insulin, Apo-B, FFA, MDA and adiponectin were examined. Data analyzed by computer using t-test for different of mean, Anova and linear regression test for significant factors (CI 95% and p < 0.05), and odd ratio for risk factors. Results. The fourty six obese patients (case 23 pts, control 23 pts) are matched to age and sex. Significant difference are shown in triglyceride, FFA and adiponectin level (p: 0.013; p: <0.001; and p: 0,045). There are no significant difference in insulin resistance, cholesterol, MDA and Apo-B level. By linear regression test, triglyceride, FFA and adiponectin level are predicted as significant factor (p<0.05) with odd ratio 1.64, 12.4, and 0.9.Conclusion. Increasing of triglyceride, FFA and adiponectin level in obesity with diabetic have risk of NAFLD prevalence with odd ratio 1.64 time (triglyceride), 12.4 (FFA) and 0.9 (adiponectin).
Diabetes Epidemiology and Management
Objective: This study aims to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD), to determine the metabolic risk factors of this disease, and to predict nonalcoholic steatohepatitis (NASH) with liver fibrosis in women of different ages and body mass index (BMI). Methods: In 2010-2011, a cross-sectional survey was conducted among 9,360 women at the health checkup center of Zhongnan Hospital (Wuhan, China). The probability of NASH with liver fibrosis was predicted using BAAT (BMI, age, alanine aminotransferase, and triglycerides) score. Results: The prevalence of NAFLD increased from 5.3% to 18.8% in women younger than 45 years versus women aged 45 to 55 years and rose to 27.8% in women older than 55 years. In obese women, the prevalence of NAFLD was 48.4%. Women older than 45 years and obese women with NAFLD had more unfavorable metabolic risk factors. Multiple regression analyses showed that increased BMI and low aspartate aminotransferaseYtoYalanine aminotransferase ratio were closely related to NAFLD in women of different ages, whereas increasing BMI, BAAT score, age, high triglycerides, alanine aminotransferase, and low aspartate aminotransferaseYtoYalanine aminotransferase ratio were all closely related to NAFLD in obese women. The prevalence of NASH with a BAAT index of 3 or higher was 13.2% and 14.9% in women older than 55 years and obese women with NAFLD, respectively. Conclusions: Obese and postmenopausal women have a high prevalence of NAFLD and severe metabolic disorders. The prevalence of NASH seems to be considerably higher in obese and postmenopausal women with NAFLD.
Nonalcoholic fatty liver disease: a marker of adipose tissue distribution
Adipobiology, 2012
Recent evidence has shifted the paradigm of white adipose tissue from simple energy storage to the body's major endocrine and paracrine organ synthesizing and releasing multiple signaling proteins, collectively termed adipokines. White adipose tissue is distributed in two large depots (subcutaneous and visceral) and many small depots associated with the heart, blood vessels, lymph nodes, ovaries, mammary glands, prostate gland, pancreas. Even in a lean person, adipose tissue represents about 15-20 % of body weight, including external (subcutaneous and visceral) and internal (organ-associated) adipose tissue, the latter being even more important than the former; however the internal fat distribution was beyond the scope of the present study. nonalcoholic fatty liver disease (naFlD) is a term used to describe the accumulation of fat in the liver of people in the absence of alcohol consumption or consumption of less than 20g/day. It is a progressive, low-grade inflammatory disease related to obesity and metabolic syndrome. naFlD represent a spectrum of disorders ranging from fat accumulation (steatosis) to nonalcoholic steatohepatitis (nash) that can progress to fibrosis and cirrhosis. The aim of the present study was to evaluate the clinic and metabolic parameters in patients with type 2 diabetes and naFlD depending on gender and bmI and to assess relation of adipose tissue distribution with insulin resistance. Total of 118 patients (mean age 55.93 years; male, 46, female, 72) with type 2 diabetes evaluated in an outpatient diabetes clinic were diagnosed with naFlD by ultrasonography and were assessed by weight, body mass index (bmI), waist circumference, fasting plasma glucose, hbalc, and fasting insulin level. We calculated the hOma-IR index [Fpg (mmol/l) x FI (μu/ml)]:22.5. body adipose percentage and trunk adipose content were measured using bioelectrical impedance analysis (TanITa bc-418). Overall, the present results suggest that insulin resistance may be considered a pathogenic link between T2Dm and naFlD, also at the level of adipose tissue distribution. Evaluating the distribution of internal, organ-associated adipose tissue remains a challenge for future studies in patients with T2Dm and naFlD.
Journal of Clinical and Experimental Hepatology, 2017
Background and aims: With the rising prevalence of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the most common liver disorder in both developed and developing nations. Several studies on NAFLD have described waist circumference, a surrogate marker of visceral fat accumulation and waist height ratio as a better screening tool for NAFLD and metabolic syndrome than body mass index (BMI). We conducted this study to assess simple abdominal obesity indices as a predictor of NAFLD and determine the appropriate cutoff levels with reference to NAFLD. Methods: 1000 subjects with NAFLD detected ultrasonographically and 360 controls attending a Gastroenterology Clinic at Cuttack, Odisha were included in the study and subjected to detailed anthropometric measurements. The abdominal anthropometric cut offs were determined using ROC analysis. Statistical analysis was performed by using SPSS software version 16. Results: All receiver operating curve (ROC) curves of waist circumference, waist-height ratio and BMI were significantly above the diagonal line. There were no significant differences in the area under the curve values among these abdominal obesity indices in each gender. The appropriate cutoff point of waist circumference in screening for NAFLD was 89 cm for men and 84 cm for women and the optimal cutoff point of waist-height ratio was 0.53 for men and 0.57 for women and the cutoff point of waist to hip ratio was 0.94 for men and 0.87 for women with very good sensitivity and specificity. Conclusions: The simple anthropometric parameters, such as BMI, waist circumference, waist-hip ratio and waist-height ratio are useful for predicting NAFLD in Indian adults. The anthropometry cut offs would be very useful in setting target points of life style modification and weight reduction. Besides, our study also clearly demonstrated that a simple assessment of BMI is as efficacious as other anthropometry parameters in predicting NAFLD.
NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) AMONG OBESE PATIENTS IN A TERTIARY CARE HOSPITAL
National Journal of Medical Research, 2023
Background: Non-alcoholic fatty liver disease (NAFLD) commonly results in cirrhosis and liver related death. Obesity is associated with an increased risk of non-alcoholic fatty liver disease. NAFLD has become an important public health problem throughout the globe. The aim of this study was to see frequency of NAFLD among obese patients admitted at the Department of Medicine of Mymensingh Medical College Hospital. Methods: A total of 100 obese patients having BMI ≥25 kg/M2 were included in this cross-sectional study. Patients’ characteristics, laboratory and face-to-face interview data were analyzed. Results: Mean age of the patients was 52.61 (SD ± 7.02) years. It was found that more patients were from 51-60 years age group (39%); followed by 41-50 years age group (28%). NAFLD was found in 79% of obese adult patients. Laboratory parameters including TG, HDL, FBG and high blood pressure were compared between NAFLD and normal obese groups. There were no significant differences between the two groups except for FBG. NAFLD patients suffered more from high blood sugar than normal obese patients. Higher intake of meat, increased smoking, lower intake of fish, higher intake of soft drinks & FBG value over 6.1 mmol/L were identified as risk factors for the development of NAFLD. Conclusion: NAFLD is emerging as one of the most common liver disorders claiming urgent attention of the public, clinicians and researchers. Further in-depth, large scale prospective studies are necessary to dig out more information in this topic
Hepatology, 2007
The patterns of fat distribution and their relationship to severity of nonalcoholic fatty liver disease (NAFLD) are unknown. The objectives of this study were to define the fat distribution patterns and their relationship to histological severity and metabolic parameters in subjects with NAFLD. Anthropometric indices and total body fat were measured in 123 subjects. Fat distribution patterns were defined as: general, abdominal, limb, truncal, and dorsocervical lipohypertrophy (DCL) a novel finding in NAFLD. Eighty-one (66%) of the subjects were obese, and 94 (76%) had abdominal obesity. Thirty-five (28.5%) had DCL. Whereas body mass index (BMI) correlated best with the presence of diabetes (r ؍ 0.22, P < 0.05), waist circumference (WC) correlated best with hypertension (r ؍ 0.2, P < 0.05), hypertriglyceridemia (r ؍ 0.37, P < 0.001), and insulin resistance (homeostasis model of assessment for insulin resistance [r ؍ 0.68, P < 0.0001]). None of the patterns of fat distribution were significantly associated with severity of hepatic steatosis. Abdominal obesity (WC) correlated with inflammation (r ؍ 0.2, P < 0.05) only. DCL correlated significantly with the severity of all histological parameters except steatosis. Whereas DCL was the single greatest contributor to the variability in severity of histological parameters, a model combining BMI, WC, and DCL showed the greatest contribution to the variability in severity of individual histological parameters. The addition of steatosis grade to the model significantly increased its contribution to the range of lobular inflammation. Conclusion: WC predicts metabolic risk profile with the most significance. However, DCL is most strongly associated with severity of steatohepatitis. WC and BMI added modestly to the contribution of DCL to severity of nonalcoholic steatohepatitis. (HEPATOLOGY 2007;46:1091-1100.) Abbreviations: BMI, body mass index; DCL, dorsocervical lipohypertrophy; HOMA-IR, homeostasis model of assessment for insulin resistance; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; WC, waist circumference. From the