Correlation of waist circumference, hip circumference and waist-hip ratio with VCTE in lean and non-lean NAFLD

Abstract

Background and Aim: Waist circumference (WC) is a measure of abdominal adiposity, an important predictor of Non alcoholic fatty liver disease (NAFLD). Waist-to-hip ratio (WHR) also has a strong correlation with development of NAFLD. Vibration-controlled transient elastography (VCTE) is a widely used noninvasive technique for assessment of liver fibrosis. We tried to compare the WC, Hip circumference (HC) and WHR in lean and non lean NAFLD and to assess the correlation between WHR and VCTE. Methods: Cross-sectional observational study including 120 lean (BMI<23kg/m2 ) and 120 non-lean (BMI>23kg/m2 ) NAFLD patients. Liver stiffness was determined using VCTE (Fibroscan 502, Echosens, Paris, France) in kilopascals (kPa). Comparison of categorical variables was done using Chi-square (Î2) test. Pearson’s correlation coefficient was used to test the strength of correlation. Univariate linear regression was used to predict the relation between WHR and VCTE. Results: 105(87.5%) of non-lean NAFLD and 59(49.17%) of lean NAFLD patients were found to have high WC (p<0.001), but the proportion of patients having high WHR was comparable in both the groups (p=0.551). Compared to the lean NAFLD population, WC and HC were significantly higher in the non-lean group (p<0.001 for both), but mean WHR were comparable between lean (0.93+0.14) and non-lean (0.94+0.14) groups (p=0.639). Mean VCTE was also comparable in lean NAFLD (8.18+2.23) and non-lean NAFLD (7.74+2.54), (p=0.162). Both HC and WC had poor correlation with VCTE. Mean WHR had a moderately strong correlation with VCTE in non-lean NAFLD (r=0.326) and a weak correlation in lean NAFLD (r=0.169). On univariate linear regression, the relationship between WHR and VCTE was significant in non-lean NAFLD (Î2=5.226, p=0.002), but not in lean NAFLD (Î2=2.665, p=0.064). Conclusions: High WHR has significant correlation with liver fibrosis in non-lean NAFLD, but not in lean NAFLD. Individually, WC and HC do not correlate significantly with VCTE.