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)
Journal of the Indian Medical Association, 2009
Recently detected 152 IGT and 158 type 2 diabetes patients aged between 30 and 69 years, never treated with any antidiabetic drug, lipid lowering agent, angiotension converting enzyme (ACE) inhibitor and/or angiotensin receptor blocker (ARB) were evaluated. One hundred and sixty asymptomatic, willing, healthy, normoglycaemic spouse or unrelated attendants accompanying the patients were also selected. History of significant alcohol intake or hepatotoxic drugs and positive serologic findings for hepatitis B and C viruses were excluded. The prevalence of fatty liver was 64% in type 2 DM, 52% in impaired glucose tolerance (IGT) and 20% in normal glucose tolerance (NGT) subjects. Subjects with fatty liver had significantly higher body mass index (BMI), waist, waist hip ratio, waist to height ratio, triglyceride, fasting insulin, insulin resistance (HOMA-IR), along with significantly lower HDL-C and quantitative insulin-sensitivity check index (QUICKI) compared to those without fatty live...
Indian Journal of Endocrinology and Metabolism, 2013
Background: Obesity is an important risk factor for non-alcoholic fatty liver disease (NAFLD); however, NAFLD does occur in lean subjects. This study was aimed to evaluate the magnitude, clinical, pathological, and metabolic profi les of NAFLD in normal body mass index (BMI) subjects (defi ned as lean NAFLD) in comparison to overweight or obese NAFLD and lean healthy control. Materials and Methods: 336 subjects (205 consecutive NAFLD, and 131 healthy controls) were studied. Results: Among 205 NAFLD patients, 27 (13.2%) were lean, while 141 (68.8%) and 37 (18%) patients were obese and overweight, respectively. The lean NAFLD compared to obese NAFLD had signifi cantly lesser degree of fasting hyperinsulinemia (P<0.001), homeostasis model assessment insulin resistance (HOMA-IR, P<0.001), and lower prevalence of diabetes mellitus (P=0.01) and metabolic syndrome (P<0.001). The profi les of serum lipids were similar between all 3 BMI categories, and 89% of lean NAFLD were dyslipidemic. Compared to obese subjects, patients with lean NAFLD had less hepatic necro-infl ammation (P=0.05) and fi brosis (P<0.001). However, the proportion of steatohepatitis and advanced fi brosis were similar between all BMI categories. The profi les of overweight NAFLD were similar to those of lean NAFLD, except for higher HOMA-IR, uric acids and male gender in overweight group. Despite being lean, the mean BMI of lean NAFLD were still higher than unselected lean healthy controls (P=0.02). Conclusions: Lean NAFLD patients have less severe disease, minor, or no insulin resistance, but are frequently dyslipidemic and have BMI higher than lean healthy control.
Integrative Gastroenterology and Hepatology, 2019
Background: Non-alcoholic fatty liver disease (NAFLD) is now predominant globally due to increased sedentary lifestyle and obesity. Recently, high prevalence of NAFLD also has been documented in non-obese individuals with increased risk of cirrhosis and hepatocellular carcinoma. The systemic and hepatic manifestations of NAFLD severity in obese and non-obese Indian patients are not clear.Methods: The clinically diagnosed NAFLD patients (n=54, non-obese and obese) were assessed for liver injury and hepatic fat content by histopathology, Fibroscan and MRS. Liver biopsy and hepatic venous sampling were performed by trans-jugular approach and mRNA expression was assessed by real-time PCR.Result: High liver fat content (LFC, 20. 4 ± 10. 4%, 16 ± 11. 5% and 9. 34 ± 15. 4%) and increased abdominal obesity (WHR, 1. 03 ± 0. 06, 0. 97 ± 0. 05 and 0. 93 ± 0. 06) was observed in both obese and non-obese NAFLD patients as compare to disease control. Histopathological examination of liver indicat...
Metabolic syndrome and related disorders, 2015
To assess the prevalence of nonalcoholic fatty liver (NAFL) in Iran and to evaluate correlates of NAFL in categories of body mass index (BMI). Using a cluster random sampling approach, 7723 subjects over 18 years of age underwent abdominal ultrasonography, laboratory evaluations, blood pressure, and anthropometric measurements and were interviewed to obtain baseline characteristics. Prevalence of NAFL according to BMI and waist to hip ratio and its association with metabolic abnormalities in categories of BMI were assessed in multivariate analysis. The overall prevalence of NAFL was 35.2% [95% confidence interval (CI) 34.1-36.3]. A significant number of subjects with BMI <30 had NAFL [22.1% (CI 21.0-23.2)]. Waist to hip ratio for 38.2% (CI 35.6-40.8) of the subjects with NAFL, and BMI <30 was higher than normal values. The odds ratio for association of NAFL and dyslipidemias were higher in subjects with BMI <30 versus those with BMI ≥30: (1) hypertriglyceridemia: 2.21 vs. 1...
Correlation between body fat mass and nonalcoholic fatty liver disease
Medical and Health Science Journal, 2011
The study analyzes the impact of a body fat mass onto body composition, as muscle mass, water mass, and bone mass of a body, and also onto such physical parameters, as the basal metabolic ratio (BMR), metabolic age, a bioimpedance in patients with nonalcoholic fatty liver disease (NAFLD). The research included 58 people, of them 32 patients with NAFLD. There were studied anthropometrical indicators, as age, weight, body mass index, also parameters of body composition. In patients group in compare with control group there were significantly raised a visceral fat rating on 3.1 units (р<0.0001), a metabolic age on 9.6 years (р<0.0001), a basal metabolic rate on 209 kkcal/day (р=0.004), a bioimpedance on 25.7 Ohm (р=0.04). In control group in compare with patients group there were significantly raised the percentage of total body water on 9.9% (р<0.0001), the percentage of muscle mass on 13.1% (р<0.0001), and the percentage of bone mass on 0.7% (р<0.0001). BMR starts to be slowed down when fat mass accumulation in organism is between 30 and 40%, and after 40% the BMR starts to go down. Bioimpedance values increases with rises of fat mass in percentage.
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.