Abstract
Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. Cross-sectional study at the ELSA-Brasil centers of six public research institutions. This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is characterized by a primary form of excessive fat accumulation in hepatocytes, which stands out because of its potential to evolve into inflammatory conditions, steatohepatitis, fibrosis, cirrhosis and hepatocellular carcinoma.[1,2,3] diagnosed worldwide, it has variations in prevalence
Neck circumference (NC) was associated with NAFLD with a higher odds ratios (ORs) in relation to a mild degree of NAFLD (OR = 1.23, 95% confidence interval (95% CI): 1.19-1.27 for women; OR = 1.20, 95% CI: 1.17-1.24 for men) and a moderate/severe degree of NAFLD (OR = 1.56, 95% CI: 1.50-1.62 for women; OR = 1.45, 95% CI: 1.40-1.50 for men), compared with the reference category
Recent studies on Asian populations showed that NC was associated with NAFLD, in addition to the traditional indexes used (BMI and Waist circumference (WC))
Summary
Non-alcoholic fatty liver disease (NAFLD) is characterized by a primary form of excessive fat accumulation in hepatocytes, which stands out because of its potential to evolve into inflammatory conditions, steatohepatitis, fibrosis, cirrhosis and hepatocellular carcinoma.[1,2,3] diagnosed worldwide, it has variations in prevalence. For NAFLD, ultrasound (USG) is considered to be a more accessible and reasonable diagnostic examination, compared with other imaging tests and with hepatic biopsy (the gold standard method).[7] Transaminases tests, in turn, are not good diagnostic parameters because of their low specificity, since NAFLD does not always lead to liver enzyme abnormalities. These tests should only be used as complements for another method.[6,8,9] Both in epidemiological studies and in clinical practice, anthropometric indicators have been used as a proxy for NAFLD because they are more available, noninvasive and cost-effective than other existing methods used for assessing NAFLD.[10]. Some studies in other countries have demonstrated use of NC measurements as a predictor of NAFLD among obese and non-obese adult individuals, independent of other anthropometric indexes.[14,15,16,19,30]
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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