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Body Fat Distribution and Risk of Incident and Regressed Nonalcoholic Fatty Liver Disease

Published on Jan 1, 2016in Clinical Gastroenterology and Hepatology7.958
· DOI :10.1016/j.cgh.2015.07.024
Donghee Kim33
Estimated H-index: 33
(Stanford University),
Goh Eun Chung16
Estimated H-index: 16
(Seoul National University Hospital)
+ 7 AuthorsChung Yong Kim31
Estimated H-index: 31
(SNU: Seoul National University)
Abstract
Background & Aims Some studies have examined correlations between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with nonalcoholic fatty liver disease (NAFLD) or between VAT and NAFLD. We investigated the longitudinal association between body fat distribution (VAT vs SAT) and incidence and regression of NAFLD, adjusting for risk factors, in a large population-based cohort. Methods We collected data from adults who underwent abdominal ultrasonography (to identify liver fat), abdominal fat computed tomography scan, and blood tests from March 2007 through December 2008. Each patient underwent an anthropometric assessment and completed a questionnaire about their medical history, physical activity, and diet. Our final analysis involved 2017 subjects from the initial cohort who participated in a voluntary follow-up health screen performed in 2011 and 2013. The median follow-up time was 4.43 years. Results We found 288 incident cases of NAFLD; 159 patients had NAFLD regression during the follow-up period. An increasing area of VAT was associated with higher incidence of NAFLD in the multivariable analysis (highest quintile vs lowest quintile of VAT hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.28−3.89; P for trend = .002; HR, 1.36 [per 1 standard deviation]; 95% CI, 1.16−1.59). An increased area of SAT was significantly associated with regression of NAFLD (highest quintile vs lowest quintile of SAT HR, 2.30; 95% CI, 1.28–4.12; P for trend= .002; HR, 1.36 [per 1 standard deviation]; 95% CI, 1.08−1.72). Conclusions In a large cohort study, larger areas of VAT were longitudinally associated with higher risk of incident NAFLD (during a period of approximately 4 years). In contrast, larger areas of SAT were longitudinally associated with regression of NAFLD. These data indicate that certain types of body fat are risk factors for NAFLD, whereas other types could reduce risk for NAFLD.
  • References (40)
  • Citations (30)
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References40
Newest
#1Steve C.L. Lin (UCSD: University of California, San Diego)H-Index: 12
#2Elhamy Heba (UCSD: University of California, San Diego)H-Index: 13
Last. Rohit Loomba (UCSD: University of California, San Diego)H-Index: 64
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Background & Aims Liver biopsy analysis is the standard method used to diagnose nonalcoholic fatty liver disease (NAFLD). Advanced magnetic resonance imaging is a noninvasive procedure that can accurately diagnose and quantify steatosis, but is expensive. Conventional ultrasound is more accessible but identifies steatosis with low levels of sensitivity, specificity, and quantitative accuracy, and results vary among technicians. A new quantitative ultrasound (QUS) technique can identify steatosis...
90 CitationsSource
#1Min Sun Kwak (Seoul National University Hospital)H-Index: 9
#2Donghee Kim (Seoul National University Hospital)H-Index: 33
Last. Jung-Hwan Yoon (SNU: Seoul National University)H-Index: 46
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Background & Aims Limited evidence supports a role for physical activity (PA) in nonalcoholic fatty liver disease (NAFLD) independent of visceral obesity or/and insulin resistance. We investigated the association between PA and NAFLD while considering visceral adipose tissue (VAT) and insulin resistance in a large general population. Methods Nonalcoholic fatty liver disease was diagnosed based on typical ultrasonographic findings. A detailed PA questionnaire included type, frequency, duration an...
23 CitationsSource
#1Niraj S. Patel (UCSD: University of California, San Diego)H-Index: 6
#2Iliana Doycheva (UCSD: University of California, San Diego)H-Index: 6
Last. Rohit Loomba (UCSD: University of California, San Diego)H-Index: 64
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Background & Aims Little is known about how weight loss affects magnetic resonance imaging (MRI) of liver fat and volume or liver histology in patients with nonalcoholic steatohepatitis (NASH). We measured changes in liver fat and liver volume associated with weight loss by using an advanced MRI method. Methods We analyzed data collected from a previous randomized controlled trial in which 43 adult patients with biopsy-proven NASH underwent clinical evaluation, biochemical tests, and MRI and liv...
53 CitationsSource
#1Mazen Noureddin (UCSD: University of California, San Diego)H-Index: 18
#2Jessica LamH-Index: 5
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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated serum aminotransferase levels in the United States.1–3 It has been estimated that approximately 80 million Americans have NAFLD, and the prevalence of this condition is expected to rise with the continuing epidemic of obesity.4,5 Nonalcoholic steatohepatitis (NASH), which is the progressive form of NAFLD, is typically associated with inflammation and cellular injury in addition to steatosis with or without perisinusoid...
188 CitationsSource
#1David van der Poorten (USYD: University of Sydney)H-Index: 17
#2Caroline Flora Samer (Geneva College)H-Index: 19
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Advanced liver fibrosis in nonalcoholic steatohepatitis (NASH) is often accompanied by a reduction in hepatic fat to the point of complete fat loss (burnt-out NASH), but the mechanisms behind this phenomenon have not been elucidated. Adiponectin is raised in cirrhosis of any cause and has potent antisteatotic activity. In this study we examined 65 patients with advanced biopsy-proven NASH (fibrosis stage 3-4) and 54 with mild disease (fibrosis stage 0-1) to determine if disappearance of steatosi...
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Summary Non-alcoholic fatty liver disease (NAFLD) affects one in every three subjects in the occidental world. The vast majority will not progress, but a relevant minority will develop liver cirrhosis and its complications. The classical gold standard for diagnosing and staging NAFLD and assessing fibrosis is liver biopsy (LB). However, it has important sample error issues and subjectivity in the interpretation, apart from a small but real risk of complications. The decision to perform an LB is ...
188 CitationsSource
#1Donghee Kim (Mayo Clinic)H-Index: 33
#2W. Ray Kim (Mayo Clinic)H-Index: 59
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In the past 25 years, the prevalence of obesity in the US has more than doubled, a trend that continues today without signs of slowing down.(1, 2) In parallel, non-alcoholic fatty liver disease (NAFLD) has been recognized as the most prevalent liver disease in the US and in many parts of the world.(2, 3) The natural history of NAFLD, however, is incompletely understood and its clinical and public health significance remains a matter of debate. NAFLD is a clinicopathological entity that encompass...
278 CitationsSource
#1Rexford S Ahima R S (UPenn: University of Pennsylvania)H-Index: 67
#2Suzette Y. Osei (UPenn: University of Pennsylvania)H-Index: 3
Adipose tissue is the source of soluble mediators (adipokines), secreted mainly by adipocytes. Leptin acts on the brain and peripheral organs to regulate energy homeostasis and the neuroendocrine axi
216 CitationsSource
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#2Su Yeon Choi (Seoul National University Hospital)H-Index: 6
Last. W. Ray Kim (Mayo Clinic)H-Index: 59
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Nonalcoholic fatty liver disease (NAFLD) is related to risk factors of coronary artery disease, such as dyslipidemia, diabetes, and metabolic syndrome, which are closely linked with visceral adiposity. The aim of this study was to investigate whether NAFLD was associated with coronary artery calcification (CAC), which is used as a surrogate marker for coronary atherosclerosis independent of computed tomography (CT)-measured visceral adiposity. Out of 5,648 subjects who visited one of our health ...
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Abstract Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease with a worldwide prevalence of 25%. In the US, NAFLD and its subtype, nonalcoholic steatohepatitis (NASH), affect 30% and 5% of the population, respectively. Considering the ongoing obesity epidemic beginning in childhood, the rise in Diabetes and other factors, the prevalence of NAFLD along with the proportion of those with advanced liver disease is projected to continue to increase. This will have an important i...
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: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and encompasses a spectrum of pathology from simple steatosis to inflammation and significant fibrosis that leads to cirrhosis. NAFLD and its comorbid conditions extend well beyond the liver. It is a multisystemic clinical disease entity with extrahepatic manifestations such as cardiovascular disease, type 2 diabetes, chronic kidney disease, hypothyroidism, polycystic ovarian syndrome, and psoriasis. Indeed, the ...
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BACKGROUND: We evaluated the association of visceral-to-subcutaneous fat ratio (VSR) with nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis degree based on noninvasive serum fibrosis markers in the general population with NAFLD. METHODS: This is a cross-sectional study, in 7,465 Korean adults who underwent health screening examinations. NAFLD was defined as fatty liver detected on ultrasonography, and visceral and subcutaneous abdominal fat was measured using computed tomography. We...
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#1Goh Eun Chung (Seoul National University Hospital)H-Index: 16
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Individuals with non-alcoholic fatty liver disease (NAFLD) who lack classical risk factors also have the ability to develop nonalcoholic steatohepatitis (NASH) and progression to more advanced liver disease. The pathophysiology and risk factors for the development of NAFLD in non-obese persons are not fully understood but seem to be closely related to insulin resistance, atherogenic dyslipidaemia and alterations in body composition, with some patients harbouring predisposing genetic polymorphism...
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