Abstract
BackgroundNonalcoholic fatty liver disease (NAFLD) is closely related with obesity. However, obese subjects, generally represented by high BMI, do not always develop NAFLD. A number of possible causes of NAFLD have been studied, but the exact mechanism has not yet been elucidated.MethodsA total of 304 consecutive subjects who underwent general health examinations including abdominal ultrasonography, transient elastography and abdominal fat computed tomography were prospectively enrolled. Significant steatosis was diagnosed by ultrasonography and controlled attenuation parameter (CAP) assessed by transient elastography.ResultsVisceral fat area (VFA) was significantly related to hepatic steatosis assessed by CAP, whereas body mass index (BMI) was related to CAP only in univariate analysis. In multiple logistic regression analysis, VFA (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.001–1.019; P = 0.028) and triglycerides (TG) (OR, 1.006; 95% CI, 1.001–1.011; P = 0.022) were independent risk factors for significant hepatic steatosis. The risk of significant hepatic steatosis was higher in patients with higher VFA: the OR was 4.838 (P<0.001; 95% CI, 2.912–8.039) for 100<VFA≤200 cm2 and 7.474 (P<0.001; 95% CI, 2.462–22.693) for VFA >200 cm2, compared to patients with a VFA ≤100 cm2.ConclusionsOur data demonstrated that VFA and TG is significantly related to hepatic steatosis assessed by CAP not BMI. This finding suggests that surveillance for subjects with NAFLD should incorporate an indicator of visceral obesity, and not simply rely on BMI.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide
In multiple logistic regression analysis, Visceral fat area (VFA) and triglycerides (TG) (OR, 1.006; 95% confidence interval (CI), 1.001–1.011; P = 0.022) were independent risk factors for significant hepatic steatosis
The risk of significant hepatic steatosis was higher in patients with higher VFA: the Odds ratio (OR) was 4.838 (P
Summary
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Severe forms of NAFLD such as nonalcoholic steatohepatitis can progress to end-stage liver disease such as cirrhosis or hepatocellular carcinoma [1,2,3]. Investigating risk factors associated with hepatic steatosis is required to perform effective screening. Hepatic steatosis develops for a variety reasons, but obesity is the most common associated condition [4] and vice versa. The recommended BMI cut-off value for obesity is > 25 kg/m2 for Asians, in contrast to > 30 kg/m2 for Western individuals [5]. Nonalcoholic fatty liver disease (NAFLD) is closely related with obesity. Obese subjects, generally represented by high BMI, do not always develop NAFLD. A number of possible causes of NAFLD have been studied, but the exact mechanism has not yet been elucidated
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