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Chirapongsathorn S, Jinatongthai P, Sirichana S, Boonyavarakul A, Treeprasertsuk S, Sansanayudh N. Correlation between neck circumference and hepatic steatosis determined by controlled attenuation parameter. Clin Obes 2024; 14:e12647. [PMID: 38362675 DOI: 10.1111/cob.12647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/27/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
Neck circumference is an attractive method for determining metabolic profiles and has many advantages over waist circumference. However, the correlation between neck circumference and hepatic fibrosis has not been evaluated. The aim of this study was to evaluate the correlation between neck circumference and hepatic fibrosis and define the optimal cut-off point for neck circumference to determine hepatic fibrosis. A cross-sectional study (n = 333) was conducted among Thai healthcare workers at Phramongkutklao Hospital who received an annual health maintenance program. Neck circumference was measured at the lower margin of the laryngeal prominence. Fibroscan® with a controlled attenuation parameter was used to measure the degree of hepatic fibrosis and steatosis by an experienced, well-trained operator. In the cross-sectional analysis, it was found that the large circumference of the neck was associated with hepatic fibrosis (r = 0.19, p = .001) and hepatic steatosis (r = 0.58, p < .001). Hepatic fibrosis (r = 0.15, p = .004) and steatosis (r = 0.53, p < .001) were also associated with waist circumference. The neck circumferences of 40 and 34 cm were the best cut-offs for male and female participants, respectively.Neck circumference is closely related to hepatic fibrosis and steatosis, which should be promoted and has a better advantage than waist circumference in the screening of hepatic steatosis.
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Affiliation(s)
- Sakkarin Chirapongsathorn
- Division of Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Pakapop Jinatongthai
- Division of Gastroenterology and Hepatology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Sudatip Sirichana
- Department of Family Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Apussanee Boonyavarakul
- Division of Endocrinology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Sombat Treeprasertsuk
- Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nakarin Sansanayudh
- Divison of Cardiology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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Pereira LMC, de Souza MFC, Aidar FJ, Getirana-Mota M, dos Santos-Junior AM, Filho MFDDS, Almeida-Santos MA, Rocha RMS, de Almeida RR, Baumworcel L, Costa LHSDM, Mendes RR, Sousa ACS. Wrist Circumference Cutoff Points for Determining Excess Weight Levels and Predicting Cardiometabolic Risk in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:549. [PMID: 38791764 PMCID: PMC11120788 DOI: 10.3390/ijerph21050549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/26/2024]
Abstract
(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with adults aged 20 to 59 years old, attending the outpatient clinic at University Hospital/Federal University of Sergipe HU/UFS-EBSERH. Demographic, anthropometric, biochemical, and blood pressure (BP) data were collected. Cardiometabolic risk was assessed, according to the global risk score (ERG) and Framingham score criteria. The descriptive analysis included calculating medians and frequencies of anthropometric, demographic, biochemical, and blood pressure variables. The gender and age of adult groups were compared using the Mann-Whitney test. Spearman's correlation coefficient and multiple regression analysis were used to assess the association between wrist circumference (WrC) and the variables mentioned above. The predictive validity of WrC in identifying excess weight levels and cardiometabolic risk was analyzed using the ROC curve. The sample consisted of 1487 adults aged 20 to 59 years, 55.7% of whom were female; (3) Results: WrC correlated positively with other adiposity indicators such as waist circumference and Body Mass Index. WrC was the anthropometric indicator most significantly associated with cardiometabolic risk factors. WrC cutoff points identified by the study for determining excess weight were categorized by gender and age group. For males aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 17.1 cm and 17.3 cm, and for obesity, 17.9 cm and 17.5 cm. For females aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 15.6 cm and 15.4 cm, and for obesity, 16.1 cm and 16 cm (4). Conclusions: Wrist circumference showed a significant correlation with other adiposity indicators and can be used to identify adults with excess weight and predict cardiometabolic risk.
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Affiliation(s)
- Larissa Monteiro Costa Pereira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49100-676, Brazil; (L.M.C.P.); (R.M.S.R.); (R.R.d.A.); (A.C.S.S.)
| | - Márcia Ferreira Cândido de Souza
- Graduate Program in Nutritional Sciences, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil; (M.F.C.d.S.); (A.M.d.S.-J.); (M.F.D.d.S.F.)
| | - Felipe J. Aidar
- Graduate Program in Physiological Sciences, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil;
- Graduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil
| | - Márcio Getirana-Mota
- Graduate Program in Physiological Sciences, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil;
- Graduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil
| | - Alex Menezes dos Santos-Junior
- Graduate Program in Nutritional Sciences, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil; (M.F.C.d.S.); (A.M.d.S.-J.); (M.F.D.d.S.F.)
| | | | | | - Raysa Manuelle Santos Rocha
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49100-676, Brazil; (L.M.C.P.); (R.M.S.R.); (R.R.d.A.); (A.C.S.S.)
| | - Rebeca Rocha de Almeida
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49100-676, Brazil; (L.M.C.P.); (R.M.S.R.); (R.R.d.A.); (A.C.S.S.)
| | - Leonardo Baumworcel
- Division of Cardiology, University Hospital of Federal University of Sergipe (UFS), Aracaju 49100-000, Brazil;
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, Brazil;
| | | | - Renata Rebello Mendes
- Department of Nutrition, Federal University of Sergipe (UFS), São Cristóvão 49100-000, Brazil;
| | - Antônio Carlos Sobral Sousa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49100-676, Brazil; (L.M.C.P.); (R.M.S.R.); (R.R.d.A.); (A.C.S.S.)
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, Brazil;
- Department of Medicine, Federal University of Sergipe (UFS), Aracaju 49100-000, Brazil
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Huneault HE, Gent AE, Cohen CC, He Z, Jarrell ZR, Kamaleswaran R, Vos MB. Validation of a screening panel for pediatric metabolic dysfunction-associated steatotic liver disease using metabolomics. Hepatol Commun 2024; 8:e0375. [PMID: 38407264 PMCID: PMC10898657 DOI: 10.1097/hc9.0000000000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as NAFLD, is the most common liver disease in children. Liver biopsy remains the gold standard for diagnosis, although more efficient screening methods are needed. We previously developed a novel NAFLD screening panel in youth using machine learning applied to high-resolution metabolomics and clinical phenotype data. Our objective was to validate this panel in a separate cohort, which consisted of a combined cross-sectional sample of 161 children with stored frozen samples (75% male, 12.8±2.6 years of age, body mass index 31.0±7.0 kg/m2, 81% with MASLD, 58% Hispanic race/ethnicity). METHODS Clinical data were collected from all children, and high-resolution metabolomics was performed using their fasting serum samples. MASLD was assessed by MRI-proton density fat fraction or liver biopsy and cardiometabolic factors. Our previously developed panel included waist circumference, triglycerides, whole-body insulin sensitivity index, 3 amino acids, 2 phospholipids, dihydrothymine, and 2 unknowns. To improve feasibility, a simplified version without the unknowns was utilized in the present study. Since the panel was modified, the data were split into training (67%) and test (33%) sets to assess the validity of the panel. RESULTS Our present highest-performing modified model, with 4 clinical variables and 8 metabolomics features, achieved an AUROC of 0.92, 95% sensitivity, and 80% specificity for detecting MASLD in the test set. CONCLUSIONS Therefore, this panel has promising potential for use as a screening tool for MASLD in youth.
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Affiliation(s)
- Helaina E. Huneault
- Nutrition & Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA
| | - Alasdair E. Gent
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Catherine C. Cohen
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Zhulin He
- Department of Pediatrics, Pediatric Biostatistics Core, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Zachery R. Jarrell
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, Georgia, USA
| | - Rishikesan Kamaleswaran
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Miriam B. Vos
- Nutrition & Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA
- Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
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Kuang M, Sheng G, Hu C, Lu S, Peng N, Zou Y. The value of combining the simple anthropometric obesity parameters, Body Mass Index (BMI) and a Body Shape Index (ABSI), to assess the risk of non-alcoholic fatty liver disease. Lipids Health Dis 2022; 21:104. [PMID: 36266655 PMCID: PMC9585710 DOI: 10.1186/s12944-022-01717-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background Body mass index (BMI) and A Body Shape Index (ABSI) are current independent risk factors for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to explore the value of combining these two most common obesity indexes in identifying NAFLD. Methods The subjects in this study were 14,251 individuals from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA) cohort who underwent routine health examination. We integrated BMI with WC and with ABSI to construct 6 combined obesity indicators—obesity phenotypes, the combined anthropometric risk index (ARI) for BMI and ABSI, optimal proportional combination OBMI+WC and OBMI+ABSI, and multiplicative combination BMI*WC and BMI*ABSI. Several multivariable logistic regression models were established to evaluate the relationship between BMI, WC, ABSI, and the above six combined indicators and NAFLD; receiver operating characteristic (ROC) curves were drawn to compare the ability of each obesity indicator to identify NAFLD. Results A total of 2,507 (17.59%) subjects were diagnosed with NAFLD. BMI, WC, ABSI, and all other combined obesity indicators were significantly and positively associated with NAFLD in the current study, with BMI*WC having the strongest correlation with NAFLD in female subjects (OR per SD increase: 3.13) and BMI*ABSI having the strongest correlation in male subjects (OR per SD increase: 2.97). ROC analysis showed that ARI and OBMI+ABSI had the best diagnostic performance in both sexes, followed by BMI*WC (area under the curve: female 0.8912; male 0.8270). After further age stratification, it was found that ARI and multiplicative indicators (BMI*WC, BMI*ABSI) and optimal proportional combination indicators (OBMI+WC, OBMI+ABSI) significantly improved the NAFLD risk identification ability of the basic anthropometric parameters in middle-aged females and young and middle-aged males. Conclusion In the general population, BMI combined with ABSI best identified obesity-related NAFLD risk and was significantly better than BMI or WC, or ABSI. We find that ARI and the multiplicative combined indicators BMI*WC and BMI*ABSI further improved risk prediction and may be proposed for possible use in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01717-8.
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Affiliation(s)
- Maobin Kuang
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Chong Hu
- Department of Gastroenterology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Song Lu
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Nan Peng
- Medical College of Nanchang University, Nanchang of Jiangxi, 330006, Nanchang, China.,Department of Cardiology, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, 330006, Nanchang, Jiangxi, China.
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Xuan Y, Gao P, Shen Y, Wang S, Gu X, Tang D, Wang X, Zhu F, Lu L, Chen L. Association of hypertriglyceridemic waist phenotype with non-alcoholic fatty liver disease: a cross-sectional study in a Chinese population. Hormones (Athens) 2022; 21:437-446. [PMID: 35597838 DOI: 10.1007/s42000-022-00374-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/29/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of this study was to determine the association between hypertriglyceridemic waist (HTGW) phenotype and non-alcoholic fatty liver disease (NAFLD) in a middle- to older-aged Chinese population. METHODS In this cross-sectional study, a total of 9015 participants (age 40-79 years) were recruited and grouped into four phenotypes, as follows: NWNT: normal waist-normal triglyceride; NWET: normal waist-elevated triglycerides; EWNT: elevated waist-normal triglycerides; and hypertriglyceridemic waist (HTGW). Logistic regression analysis was carried out to assess the associations between HTGW phenotype and NAFLD. Receiver-operating characteristic (ROC) curves were drawn to evaluate the utility of waist circumference-triglyceride index (WTI) as a reference factor for screening for NAFLD. RESULTS HTGW phenotype had a higher prevalence of NAFLD (53.3%), diabetes (19.6%), and hypertension (79.8%) than the other three subgroups. After adjusting for age, sex, and BMI, HTGW phenotype was associated with NAFLD (odds ratio (OR) 6.12; 95% confidence interval (CI) 5.11-7.32). Further adjusted for potential confounders, the HTGW phenotype was still significantly associated with NAFLD (adjusted OR 5.18; 95% CI 4.30-6.23) regardless of gender. The subgroup analyses generally revealed similar associations across all subgroups. ROC curve analysis showed that when the maximum area under the curve was 0.748, the WTI was 90.1, and the corresponding sensitivity and specificity were 90.6 and 59.5%, respectively. CONCLUSIONS HTGW phenotype is strongly associated with NAFLD and can be used as a reference factor for NAFLD screening.
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Affiliation(s)
- Yan Xuan
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Gao
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Shen
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sujie Wang
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Gu
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dou Tang
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xun Wang
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - FanFan Zhu
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Leiqun Lu
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ling Chen
- Institute and Department of Endocrinology, Shanghai Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Vadarlis A, Chantavaridou S, Kalopitas G, Bakaloudi DR, Karanika E, Tsekitsidi E, Chourdakis M. Τhe anthropometric and biochemical profile of pediatric non-alcoholic fatty liver disease: A systematic review and a meta-analysis. Clin Nutr 2021; 41:105-121. [PMID: 34872045 DOI: 10.1016/j.clnu.2021.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/03/2021] [Accepted: 11/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and one of the leading indications for liver transplantation in adults. However, current screening methods are inadequate and are accompanied by several disadvantages. This meta-analysis aims to identify the anthropometrical and biochemical characteristics most commonly appearing in pediatric NAFLD that could contribute to the diagnosis of the disease in the every-day clinical setting. METHODS A systematic search was conducted in major electronic databases (MEDLINE, Scopus and Embase) up to 15th of August 2021. Primary outcome was the comparison of the anthropometric characteristics, whereas secondary outcomes were the comparisons of biochemical profile, lipid profile, and metabolic parameters in children with NAFLD compared with age-matched healthy controls. Quality assessment was performed with Newcastle-Ottawa Scale (NOS) and results were expressed as mean differences with 95% confidence intervals. RESULTS Sixty-four studies were included. Two different comparisons were designed regarding the body mass status. Statistically significant differences were demonstrated by comparing children with NAFLD vs lean/normal weighted controls in body weight (23.0 kg, 95% CI: 14.0-31.8, P < 0.00001), height (3.07 cm, 95% CI: 0.21-5.94, P = 0.04), ΒΜΙ (10 kg/m2, 95% CI: 8.36-11.7, P < 0.00001) and waist circumference 25.8 cm (95% CI: 20.6-30.9, P < 0.00001) and by comparing children with NAFLD vs overweight/obese controls in weight (6.81 kg, 95% CI: 3.81-9.81), height (3.18 cm, 95% CI: 1.24 to 5.13, P = 0.001), BMI (2.19 kg/m2, 95% CI: 1.76-2.62, P < 0.00001) and WC (7.35 cm, 95% CI: 6.20-8.49, P < 0.00001). CONCLUSIONS Anthropometrical and biochemical characteristics of children and adolescents with NAFLD are statistically significantly different compared to age-matched controls; these characteristics could be used to identify individuals at risk of developing NAFLD and related comorbidities.
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Affiliation(s)
- Andreas Vadarlis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Department of Gastroenterology and Hepatology, General Hospital of Thessaloniki "G. Papanikolaou", Greece
| | - Sofia Chantavaridou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; 4(th) Department of Pediatrics, General Hospital of Thessaloniki, "Papageorgiou", Greece
| | - Georgios Kalopitas
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Division of Gastroenterology and Hepatology, 1(st) Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Evangelia Karanika
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Eirini Tsekitsidi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
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Muzurović E, Mikhailidis DP, Mantzoros C. Non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome and their association with vascular risk. Metabolism 2021; 119:154770. [PMID: 33864798 DOI: 10.1016/j.metabol.2021.154770] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of non-alcoholic fatty liver disease (NAFLD), one of the most common liver diseases, is rising. About 25% of adults worldwide are probably affected by NAFLD. Insulin resistance (IR) and fat accumulation in the liver are strongly related. The association between NAFLD, metabolic syndrome (MetS) and IR is established, but an independent impact of NAFLD on vascular risk and progression of cardiovascular (CV) disease (CVD) still needs to be confirmed. This narrative review considers the evidence regarding the link between NAFLD, IR and CVD risk. There is strong evidence for a "concomitantly rising incidence" of NAFLD, IR, MetS and CVD but there is no definitive evidence regarding whether NAFLD is, or is not, an independent and significant risk factor the development of CVD. There are also considerations that type 2 diabetes mellitus (T2DM) may be a common link between NAFLD/non-alcoholic steatohepatitis (NASH) and CVD. NAFLD may be associated with widespread abnormal peri-organ or intra-organ fat (APIFat) deposition (e.g. epicardial adipose tissue) which may further contribute to CV risk. It is clear that NAFLD patients have a greater CV risk (independent or not) which needs to be addressed in clinical practice.
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Affiliation(s)
- Emir Muzurović
- Department of Internal Medicine, Endocrinology Section, Clinical Centre of Montenegro, Ljubljanska bb, 81000 Podgorica, Montenegro; Faculty of Medicine, University of Montenegro, Kruševac bb, 81000 Podgorica, Montenegro.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, UK; Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Christos Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA 02115, USA
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8
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Taha MM, Aneis YM, Mohamady HM, S. A. A, Elsayed SH. Effect of focused ultrasound cavitation augmented with aerobic exercise on abdominal and intrahepatic fat in patients with non-alcoholic fatty liver disease: A randomized controlled trial. PLoS One 2021; 16:e0250337. [PMID: 33909662 PMCID: PMC8081198 DOI: 10.1371/journal.pone.0250337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 04/02/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The study aimed to examine the effect of focused ultrasound cavitation augmented with aerobic exercise on localized abdominal and intrahepatic fat in fatty liver patients. METHODS 34 fatty liver patients aged 30-45 with a body mass index (BMI) of 30-40 kg/m2 were randomly assigned into two equally numbered groups. Group A received focused ultrasound cavitation and moderate aerobic exercise for three months, while Group B (control group) received moderate aerobic exercise only. Abdominal subcutaneous fat volume, visceral fat volume, liver-to-spleen ratio (L/S ratio), body weight, BMI, and waist circumference were measured both before and after the study period. RESULTS Both groups showed significant improvements in subcutaneous fat volume, visceral fat volume, body weight, BMI, and waist circumference relative to baseline where (P < 0.001), with a higher percentage in group A. L/S ratio only showed a significant improvement in group A. Between-group differences were noteworthy regarding L/S ratio and waist circumference where (P < 0.0001). CONCLUSION While substantial risky measures in non-alcoholic fatty liver disease have been modified by aerobic exercise, its combination with focused ultrasound cavitation causes more notable effects on the reduction of abdominal and intrahepatic fat, making it a superior option. TRIAL REGISTRATION ClinicalTrials.gov: NCT04161703.
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Affiliation(s)
- Mona Mohamed Taha
- Department of Rehabilitation, College Of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Yasser M. Aneis
- Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Alrasheedy S. A.
- Department of Internal Medicine, EL Sahel Teaching Hospital, Giza, Egypt
| | - Shereen Hamed Elsayed
- Department of Rehabilitation, College Of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
- Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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9
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Chiyanika C, Wong VWS, Wong GLH, Chan HLY, Hui SCN, Yeung DKW, Chu WCW. Implications of Abdominal Adipose Tissue Distribution on Nonalcoholic Fatty Liver Disease and Metabolic Syndrome: A Chinese General Population Study. Clin Transl Gastroenterol 2021; 12:e00300. [PMID: 33600104 PMCID: PMC7889374 DOI: 10.14309/ctg.0000000000000300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Visceral adipose tissue (VAT) has been found to play a critical role in the development of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) independent of generalized obesity. METHODS In this secondary study of prospectively acquired data, 625 participants underwent magnetic resonance spectroscopy and chemical shift fat-water separation MRI (2-point Dixon) of the liver and whole abdomen, respectively, in a 3 Tesla magnet. Whole abdominal VAT and subcutaneous adipose tissue (SAT) were extracted from the 2-point Dixon image series using an automated method. Clinical/anthropometric/blood biochemistry parameters were measured. Using region-specific body mass index, participants were classified into 3 paired subgroups (lean, overweight, and obese) and presence of NAFLD (liver fat content ≥ 5.5%). RESULTS All relevant clinical/anthropometric/blood biochemistry characteristics and liver enzymes were statistically significant between groups (P < 0.001). NAFLD was found in 12.1%, 43.8%, and 68.3% and metabolic syndrome in 51.1%, 61.9%, and 65% of the lean, overweight, and obese, respectively. Odds ratio for metabolic syndrome and NAFLD was increased by 2.73 (95% confidence interval [CI] 2.18-3.40) and 2.53 (95% CI 2.04-3.12), respectively, for 1SD increase in VAT volume while prevalence of metabolic syndrome was increased by 2.26 (95% CI 1.83-2.79) for 1SD increase in liver fat content (%). VAT/SAT ratio in the lean with fatty liver showed the highest ratio (0.54) among all the subgroups, without a significant difference between the lean and obese with NAFLD (P = 0.127). DISCUSSION Increased VAT volume/disproportional distribution of VAT/SAT may be vital drivers to the development of metabolic syndrome and NAFLD irrespective of body mass index category.
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Affiliation(s)
- Chileka Chiyanika
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Grace Lai-Hung Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Henry Lik-Yuen Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Steve C. N. Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David K. W. Yeung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie C. W. Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
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Molina-Molina E, Shanmugam H, Di Ciaula A, Grattagliano I, Di Palo DM, Palmieri VO, Portincasa P. ( 13C)-Methacetin breath test provides evidence of subclinical liver dysfunction linked to fat storage but not lifestyle. JHEP Rep 2021; 3:100203. [PMID: 33490935 PMCID: PMC7806794 DOI: 10.1016/j.jhepr.2020.100203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/24/2020] [Accepted: 10/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is characterised by the presence of hepatic steatosis in the absence of other causes of secondary hepatic fat accumulation, and is usually associated with visceral, metabolically active obesity. However, the subclinical effects of body and liver fat accumulation on liver function are still unclear. METHODS We used orally administered (13C)-methacetin and breath test to quantify the efficiency of hepatic extraction from portal blood flow and liver microsomal function in 81 participants, in relation to presence/absence of ultrasonographic NAFLD, extent of body fat accumulation, insulin resistance, dietary models, and lifestyle. RESULTS NAFLD was present in 23% of participants with normal weight, and prevalence increased with body fat and insulin resistance. Fat accumulation, NAFLD, and insulin resistance were associated with decreased hepatic extraction efficiency, and liver microsomal function was impaired in moderate-to-severe NAFLD. Caloric intake, dietary models, and lifestyles had a minor role in promoting functional changes. CONCLUSIONS The interplay between body fat accumulation, insulin resistance, and NAFLD is linked with altered hepatic extraction efficiency from blood flow and deranged microsomal function. Non-invasive diagnosis of subclinical alterations of liver function is relevant for primary and secondary prevention measures. Furthermore, the occurrence of NAFLD in lean individuals and the evidence that caloric intake, dietary models, and lifestyle played a minor role require further studies exploring the role of environmental factors in the natural history of these diseases. LAY SUMMARY Obesity is progressively increasing worldwide and is paralleled by fat accumulation in the liver (non-alcoholic fatty liver disease [NAFLD]), the most common chronic liver disease worldwide. NAFLD can alter liver structure and function, with a variety of consequences ranging from asymptomatic and subclinical alterations to cirrhosis and cancer. (13C)-Methacetin breath test, a non-invasive diagnostic tool, can reveal early subclinical alterations of liver dynamic function in individuals with obesity and in patients with NAFLD.
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Key Words
- (13C), carbon-13
- ALT, alanine aminotransferase
- ARFI, acoustic radiation force impulse
- AST, aspartate aminotransferase
- BT, breath test
- Body mass index
- DOB, delta over baseline
- FLI, fatty liver index
- GGT, gamma-glutamyl transferase
- HOMA, Homeostatic Model Assessment for Insulin Resistance
- HRQoL, health-related quality of life
- IDF, International Diabetes Federation
- KICA, ketoisocaproic acid
- Liver function
- MBT, methacetin breath test
- MD, Mediterranean diet
- MET, metabolic equivalent task
- Microsomal function
- NAFL, non-alcoholic fatty liver
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- Non-alcoholic fatty liver disease
- OR, odds ratio
- Portal blood flow
- R-ATPIII, Revised National Cholesterol Education Programme-Adult Treatment Panel III
- SF-36, 36-Item Short Form Health Survey Questionnaire
- US, ultrasonography
- cPDR, cumulative per cent dose recovery
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Affiliation(s)
- Emilio Molina-Molina
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Harshitha Shanmugam
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Agostino Di Ciaula
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | | | - Domenica Maria Di Palo
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo O. Palmieri
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Piero Portincasa
- Clinica Medica ‘A. Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
- Corresponding author. Address: Clinica Medica ‘Augusto Murri’, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy. Tel.: +39 80 5478 227; fax: +39 80 5478 232.
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Gomes KBDA, Leal VS, Oliveira JS, Pereira CGDS, Gonçalves FCLDSP, Andrade ISD, Eickmann SH, Lira PICD, Lima MDC. BIRTH WEIGHT AND OVERWEIGHT IN ADOLESCENTS: THE ERICA PROJECT IN THE CITY OF RECIFE, PERNAMBUCO. ACTA ACUST UNITED AC 2021; 39:e2019380. [PMID: 33440405 PMCID: PMC7802994 DOI: 10.1590/1984-0462/2021/39/2019380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/23/2020] [Indexed: 11/30/2022]
Abstract
Objective: To verify the association of anthropometric parameters at birth, socioeconomic and biological variables, physical activity, and parental nutritional status with overweight and abdominal obesity in adolescents. Methods: A cross-sectional study was carried out on 39 public and private schools in Recife (state of Pernambuco, Brazil). The sample consisted of 1,081 teenagers aged from 12 to 17 years. Data were collected from the Study of Cardiovascular Risks in Adolescents (ERICA). Body mass index according to age (BMI-for-age), waist circumference (WC), and waist-to-height ratio (WtHR) were considered as outcome variables, whereas the explanatory variables were birth weight, Röhrer’s Ponderal Index (RPI), biological and socioeconomic variables, physical activity, and parental nutritional status. The crude and adjusted prevalence ratios (PR) for the studied association were estimated by Poisson Regression. Results: The multivariate Poisson regression showed that the variable that remained significantly associated with overweight in adolescence was maternal overweight, PR=1.86 (95% confidence interval [95%CI] 1.09-3.17). High birth weight also remained significantly associated with abdominal obesity assessed by WC, PR=3.25 (95%CI 1.0-9.74). Conclusions: High birth weight may be a marker for abdominal obesity in adolescence; and high maternal BMI, for overweight.
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Affiliation(s)
| | - Vanessa Sá Leal
- Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brazil
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Chao HC, Lin HY. Comparison of Body Mass Index and Fat Indices in Predicting the Severity of Nonalcoholic Fatty Liver Disease Among Children Who Are Overweight and Obese. Front Pediatr 2021; 9:724426. [PMID: 34513769 PMCID: PMC8432615 DOI: 10.3389/fped.2021.724426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Information of the relationships between body mass parameters and the severity of fatty liver is deficient in pediatric nonalcoholic fatty liver disease (NAFLD). Methods: The relationships between body mass parameters (waist circumference [WC], body mass index [BMI], and abdominal subcutaneous fat thickness [ASFT]) and the severity of fatty liver were prospectively evaluated in pediatric patients who are overweight or obese, suffering from NAFLD. Ultrasonography was performed to assess fatty liver and its severity on a three-grade scale (low-grade fatty liver [LGFL], grade 1 or 2; high-grade fatty liver [HGFL], grade 3). Results: A total of 110 subjects (55 LGFL and 55 HGFL) aged 6.2-17.9 years were included. The WC, BMI, and ASFT values were significantly higher in the HGFL group compared to those in the LGFL group (p = 0.00004, 0.01, and 0.04, respectively). WC had the greatest power to predict HGFL under receiver-operating characteristic curve analyses and was positively correlated with the severity of fatty liver in subjects aged 6-12-year old and 13-17-year old (p = 0.007, and 0.0039, respectively). ASFT showed a positive correlation with the severity of fatty liver in subjects aged 13-17-year old (p = 0.04). Conclusions: WC, BMI, and ASFT are predictive of severe NAFLD among children who are overweight and obese; particularly, WC has the most predictive accuracy. Among the parameters, WC and ASFT are predictive in specific age groups.
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Affiliation(s)
- Hsun-Chin Chao
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Hsin-Yeh Lin
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
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Interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet in obese women. NUTR HOSP 2020; 34:456-464. [PMID: 32207312 DOI: 10.20960/nh.02777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: obesity is a chronic disease associated with inadequate eating habits and reduced levels of physical activity. Because of obesity, the risk for comorbidities is increased, especially for cardiovascular diseases, insulin resistance, and increased pro-inflammatory factors. The aim of the present investigation was to analyze potential correlations between pro/anti-inflammatory adipokines, glycemic index, and other markers of diet quality using a metabolic profile in women undergoing interdisciplinary weight loss therapy. Methods: thirty-two women with obesity were enrolled in a 12-week program of interdisciplinary therapy combining a clinical, nutritional, and physical exercise approach. Body composition, quality of diet, metabolic profile, and pro/anti-inflammatory adipokines were analyzed. Results: the therapy showed to be effective in reducing body weight, body mass index, and body fat. There was also an improvement in lipid profile, including total cholesterol, non-HDL-cholesterol, VLDL-cholesterol, triglycerides and glucose metabolism, including glucose, and insulin. As for food intake, there was a decrease in calorie consumption, carbohydrates, lipids, and glycemic load, and an increased consumption of proteins. Positive correlations were demonstrated between insulin concentration and waist circumference; leptin and body fat and abdominal circumference; and LDL-cholesterol fraction and total cholesterol consumption. Negative correlations were demonstrated between leptin and monosaturated fat consumption; and adiponectin and liver enzyme GGT levels. Conclusions: interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet. Our findings suggest the effectiveness and clinical relevance of the interdisciplinary clinical therapy applied for obesity.
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Guimarães MR, Santos AAD, Moura TFRD, Rocha MRD, Moura IHD, Silva ARVD. Alterações clínicas, metabólicas e resistência à insulina entre adolescentes. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar as alterações clínicas, metabólicas e sua relação com a resistência à insulina entre adolescentes. Métodos Estudo analítico, realizado com 357 adolescentes de escolas públicas estaduais de um município do Nordeste brasileiro. O formulário aplicado continha as variáveis Índice de Massa Corporal, Circunferência da Cintura, Circunferência do Pescoço, Índice de Conicidade, Pressão Arterial Média; Triglicerídeos, Glicemia, High — Density Lipoprotein Coiesteroi, Insulina e Índice Homeostasis Model Assessment, analisadas por medidas descritivas para variáveis quantitativas; e frequências para variáveis qualitativas. Foram realizados testes de associações através do Qui-quadrado e do teste Odds Ratio. Resultados A prevalência de resistência à insulina foi de 33,9%. As médias da circunferência da cintura, circunferência do pescoço, índice de conicidade, pressão arterial sistólica média e pressão arterial diastólica média estiveram elevadas respectivamente em 4,2%; 30%; 10,9%; 4,2% e 14% dos adolescentes. Os níveis de High – Density Lipoprotein colesterol estiveram diminuídos em 30,5% da amostra, ao passo que os triglicerídeos estavam elevados em 18,8%. Não foi identificada alteração na glicemia. Aqueles que apresentaram índice de massa corporal, circunferência da cintura, circunferência do pescoço, índice de conicidade e triglicerídeos com valores alterados possuíam maiores chances de apresentar resistência à insulina (OD: 3,62; 11,54; 3,50; 4,49; 3,05, respectivamente). De maneira oposta, os adolescentes com pressão arterial sistólica média, pressão arterial diastólica média e High — Density Lipoprotein colesterol alterados não apresentaram significância estatística (p<0,05). Conclusão A resistência à insulina está presente entre os adolescentes, com associações positivas e significativas com alterações clínicas e metabólicas.
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Ting YW, Wong SW, Anuar Zaini A, Mohamed R, Jalaludin MY. Metabolic Syndrome Is Associated With Advanced Liver Fibrosis Among Pediatric Patients With Non-alcoholic Fatty Liver Disease. Front Pediatr 2019; 7:491. [PMID: 31850288 PMCID: PMC6901954 DOI: 10.3389/fped.2019.00491] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) among children is a growing concern with potential significant outcome. This study aims to investigate the relationship between hepatic steatosis, metabolic syndrome, and liver fibrosis among children with obesity and diabetes mellitus. Methodology: Children aged 6-18 years old were recruited from pediatric obesity and diabetes clinic in University Malaya Medical Center (UMMC) between year 2016 and 2019. Data on basic demographics, anthropometric measurements and clinical components of metabolic syndrome were collected. Transient elastography was performed with hepatic steatosis and liver fibrosis assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) respectively. Mild, moderate and severe steatosis were defined as >248, >268, and >280 dB/m respectively, and LSM above 7.0 kPa for fibrosis stage F ≥ 2, 8.7 kPa for F ≥ 3, and 10.3 kPa for F4 (cirrhosis). Results: A total of 57 children (60% male) with median age of 13 years old were recruited. Fifty (87.7%) of the children are obese and 27 (54%) out of 50 are morbidly obese. Among 44 (77.2%) patients with steatosis, 40 (70.2%) had severe steatosis and 18 (40.9%) had developed liver fibrosis of stage 2 and above. Advanced fibrosis or cirrhosis was detected in 8 (18.2%) children with presence of steatosis. Twenty-three out of 57 (40.4%) was diagnosed with metabolic syndrome. Fibrosis is three times more likely to occur in the presence of metabolic syndrome (OR = 3.545, 95% CI: 1.135-11.075, p = 0.026). Waist circumference is a significant predictor of fibrosis after multiple regression analysis. Conclusion: Obese children with metabolic syndrome are more likely to have advanced liver fibrosis compared to those without metabolic syndrome. Waist circumference predicts development of liver fibrosis.
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Affiliation(s)
- Yi-Wen Ting
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sui-Weng Wong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azriyanti Anuar Zaini
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rosmawati Mohamed
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Uebelhack R, Bongartz U, Seibt S, Bothe G, Chong PW, De Costa P, Wszelaki N. Double-Blind, Randomized, Three-Armed, Placebo-Controlled, Clinical Investigation to Evaluate the Benefit and Tolerability of Two Dosages of IQP-AE-103 in Reducing Body Weight in Overweight and Moderately Obese Subjects. J Obes 2019; 2019:3412952. [PMID: 30863632 PMCID: PMC6377993 DOI: 10.1155/2019/3412952] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 12/03/2022] Open
Abstract
Objective This study was performed to determine the efficacy and tolerability/safety of IQP-AE-103 on body weight reduction in overweight to moderately obese adults. Methods A double-blind, randomized, placebo-controlled trial involved one hundred and eight subjects (BMI between 25 and 35 kg/m2) that were randomly assigned to either the low-dose or the high-dose IQP-AE-103 group, or the placebo group. Following a 2-week run-in period, subjects received two capsules of investigational product after three daily main meals for 12 weeks. Subjects were instructed to maintain a nutritionally balanced hypocaloric diet according to the individual's energy requirement. Body weight, body fat, and waist and hip circumference were measured at baseline, and after 2, 4, 8, and 12 weeks. Subjects also rated their feelings of hunger and fullness using visual analogue scales, and food craving on a 5-point scale at the same time intervals. Blood samplings for safety laboratory parameters were taken before and at the end of the study. Results After 12 weeks of intake, the high-dose IQP-AE-103 group had a significantly greater weight loss compared with the placebo (5.03 ± 2.50 kg vs. 0.98 ± 2.06 kg, respectively; p < 0.001) and the low-dose group (3.01 ± 2.19 kg; p=0.001). The high-dose group experienced a decrease in body fat of 3.15 ± 2.41 kg compared with a decrease of 0.23 ± 2.74 kg for the placebo group (p < 0.001). High-dose IQP-AE-103 also decreased the feeling of hunger in 66% subjects. A beneficial effect of IQP-AE-103 on the lipid metabolism was also demonstrated in the subgroup of subjects with baseline total cholesterol levels above 6.2 mmol/L. No side effects related to the intake of IQP-AE-103 were reported. Conclusions These findings indicate that IQP-AE-103 could be an effective and safe weight loss intervention. This trial is registered with NCT03058367.
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Affiliation(s)
- Ralf Uebelhack
- analyze & realize GmbH, Weißenseer Weg 111, 10369 Berlin, Germany
| | - Udo Bongartz
- analyze & realize GmbH, Weißenseer Weg 111, 10369 Berlin, Germany
| | | | - Gordana Bothe
- analyze & realize GmbH, Waldseeweg 6, 13467 Berlin, Germany
| | - Pee Win Chong
- Zaluvida Corporate Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
| | - Patricia De Costa
- InQpharm Group Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
| | - Natalia Wszelaki
- Zaluvida Corporate Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
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Ashraf H, Laway BA, Afroze D, Wani AI. Evaluation of Proinflammatory Cytokines in Obese vs Non-obese Patients with Metabolic Syndrome. Indian J Endocrinol Metab 2018; 22:751-756. [PMID: 30766812 PMCID: PMC6330875 DOI: 10.4103/ijem.ijem_206_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Obesity is one of the most common yet neglected public health problems in both the developed and developing countries. Metabolic syndrome (MS) is a multiplex of risk factor for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD) and it reflects the clustering of multiple risk factors resulting from obesity and insulin resistance. Despite its predominance in obese individuals, MS does occur in non-obese individuals. Many individuals characterised as normal weight as per their body mass index (BMI), have increased visceral adiposity thereby leading to an unfavourable inflammatory cytokine profile. There are limited studies from India with respect to inflammatory cytokines in obesity and MS in general and non-obese patients with MS in particular. MATERIALS AND METHODS An observational cross-sectional study was carried out in patients with MS with or without obesity. Anthropometric parameters such as height, weight and waist girth were measured and BMI was calculated. Serum levels of TNF-α, IL-6 and adiponectin were measured by using the enzyme-linked immunosorbent assay. RESULTS A significant proportion of individuals categorised as normal weight had an increased waist circumference which correlated with BMI, acanthosis nigricans (AN) and fatty liver. There was no statistically significant difference in the cytokine levels in obese and non-obese patients with MS; similarly among non-obese patients with MS, cytokine levels were comparable in patients with or without abdominal obesity. However, triglycerides inversely correlated with adiponectin levels and there was no significant correlation between the cytokines and other parameters of MS. CONCLUSION There was no significant difference in various metabolic and inflammatory parameters between obese and non-obese patients with MS. Even in non-obese group, there were no differences in metabolic and inflammatory markers between individuals with or without abdominal obesity. This finding indicates that apart from adipose tissue, other factors are also responsible for the development of MS and its associated proinflammatory profile. There could be a significant contribution of genetic and epigenetic factors which needs to be further explored.
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Affiliation(s)
- Hamid Ashraf
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Bashir Ahmad Laway
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Dil Afroze
- Department of Immunology and Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Arshad Iqbal Wani
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
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Santos IAD, Passos MAZ, Cintra IDP, Fisberg M, Ferreti RDL, Ganen ADP. CUT OFF VALUES FOR WAIST CIRCUMFERENCE TO PREDICT OVERWEIGHT IN BRAZILIAN ADOLESCENTS, ACCORDING TO PUBERTAL STAGING. ACTA ACUST UNITED AC 2018; 37:49-57. [PMID: 30066823 PMCID: PMC6362383 DOI: 10.1590/1984-0462/;2019;37;1;00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/05/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To establish waist circumference cut off points according to pubertal staging to identify overweight in adolescents. METHODS Longitudinal study approved by the Ethics Research Committee and conducted with 557 adolescents, aged 10 to 15 years old, selected from public schools. Waist, arm, neck and hip circumferences, body fat percentage, body mass index (BMI), height and blood pressure were measured. Pubertal staging was evaluated by Tanner self assessment scale. The Receiver Operating Characteristic Curve (ROC curve) was used to determine predictive power, sensitivity, specificity and waist circumference cut off points to detect overweight. RESULTS There was a positive correlation between waist circumference and weight, BMI, upper arm and hip circumferences, waist-to-hip ratio and blood pressure in both sexes. Cut off points for waist circumference according to pubertal stage as related to overweight in adolescents with the best performances in ROC curve were: 71.65 cm for prepubescent girls, 67.90 cm for pubescent girls, 70.25 cm for post pubescent girls, and 66.45 cm for pubescent boys. Age, weight, height, BMI, body fat percentage, arm and hip circumferences were associated to altered waist circumference. CONCLUSIONS The establishment of cut off points for waist circumference according to pubertal staging was proven a good means to identify overweight. These cut off points can be considered reliable for the Brazilian adolescent population, as the isolated use of chronological age in adolescents may underestimate their nutritional status.
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Affiliation(s)
| | | | | | - Mauro Fisberg
- Universidade Federal de São Paulo, São Paulo, SP, Brasil
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