1
|
Santos LLM, Diniz MDFHS, Goulart AC, Barreto SM, Figueiredo RC. Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil. SAO PAULO MED J 2022; 140:213-221. [PMID: 35043830 PMCID: PMC9610241 DOI: 10.1590/1516-3180.2021.0095.r2.22062021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND 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. OBJECTIVES 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. DESIGN AND SETTINGS Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS 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. RESULTS 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. CONCLUSION 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.
Collapse
Affiliation(s)
| | | | - Alessandra Carvalho Goulart
- MD, PhD. Clinical Epidemiologist and Researcher, Center of Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo (HU-USP), São Paulo (SP), Brazil.
| | - Sandhi Maria Barreto
- MD, PhD. Professor, Medical School and Clinical Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | | |
Collapse
|
2
|
Different levels of physical activity and anthropometric profile in patients infected with hepatitis C virus. BIOMEDICAL HUMAN KINETICS 2019. [DOI: 10.2478/bhk-2019-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: To verify the relationship between different durations of regular practice of physical activity in aspects related to the anthropometric profile and hepatic function of patients infected by hepatitis C virus (HCV). Material and methods: 125 patients (aged 55.2 ± 10.4 years) participated in the study. Clinical data were obtained through medical records available at the Pernambuco Liver Institute. Physical activity levels were obtained through the International Physical Activity Questionnaire (IPAQ) short form to classify the patients according to the guidelines of the American College of Sports Medicine (ACSM). Results: Significant differences were found in GGT 141 (28-378 U/L) and HDL 39 (27-56 mg/dL) respectively in insufficiently active and physically active groups, AST 71 (26-268 U/L), ALT 83 (36-452 U/L), GGT 78 (3-532 U/L), alkaline phosphatase 74 (47-302 mg/dL) and total bilirubin 0.7 (0.1-2.8 mg/dL) in insufficiently active and very physically active groups. Anthropometric data showed significant differences in chest (p < 0.01), abdomen (p < 0.02) and waist measurement (p < 0.01) between insufficiently active and very physically active groups.
Conclusion: Physical activity, when practiced regularly for more than 300 minutes per week, can improve the clinical and anthropometric profile in patients infected with HCV.
Collapse
|
3
|
Bruch JP, Álvares-DA-Silva MR, Alves BC, Dall'alba V. REDUCED HAND GRIP STRENGTH IN OVERWEIGHT AND OBESE CHRONIC HEPATITIS C PATIENTS. ARQUIVOS DE GASTROENTEROLOGIA 2017; 53:31-5. [PMID: 27281502 DOI: 10.1590/s0004-28032016000100007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/02/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis C is a liver disease that causes significant changes in metabolism, and also has an impact on nutritional status. OBJECTIVE To evaluate the nutritional status and cardiovascular risk in patients with chronic hepatitis C. METHODS This cross-sectional study investigated 58 patients with chronic hepatitis C, non-cirrhotic and were not under active pharmacological treatment. Patients with significant alcohol consumption (greater than 10 g ethanol/day) were excluded. Patients underwent nutritional assessment through anthropometric measurements and functional assessment using hand grip strength by dynamometry. The physical activity was assessed using the International Physical Activity Questionnaire. Patients also underwent clinical and laboratory evaluation. Cardiovascular risk was calculated by the Framingham score. RESULTS The mean age of patients was 51.6±9.7 years, 55.2% were female, and 79.3% had genotype 1. The most prevalent degree of fibrosis was F1 (37.9%) followed by F2 (27.6%) and F3 (1.7%). The prevalence of overweight/obesity considering the body mass index was 70.7%. However, 57.7% of men and 68.8% of women were considered malnourished according to hand grip strength. These patients also had waist circumference (93.5±10.7 cm) and neck circumference (37.0±3.6 cm) high. Almost 60% of patients were considered sedentary or irregularly active. In relation to cardiovascular risk, 50% of patients had high risk of suffering a cardiovascular event within 10 years. CONCLUSION Although most patients with hepatitis C presented overweight, associated with high cardiovascular risk, they also have reduced functional capacity, indicative of protein-caloric commitment. Therefore, body mass index can not be considered the only method of assessment for nutritional diagnosis of patients with liver disease. Adopting methods such as hand grip strength can be important for a better understanding of nutritional status of these patients.
Collapse
Affiliation(s)
- Juliana Paula Bruch
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Mário Reis Álvares-DA-Silva
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Departamento de Medicina Interna, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Departamento de Medicina Interna, Faculdade de Medicina, UFRGS, Porto Alegre RS , Brazil.,Divisão de Gastroenterologia, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Divisão de Gastroenterologia, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Bruna Cherubini Alves
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Valesca Dall'alba
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil.,Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre RS , Brazil.,Divisão de Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Divisão de Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| |
Collapse
|
4
|
Nonalcoholic Fatty Liver Disease Relationship with Metabolic Syndrome in Class III Obesity Individuals. BIOMED RESEARCH INTERNATIONAL 2015; 2015:839253. [PMID: 26120587 PMCID: PMC4450272 DOI: 10.1155/2015/839253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/03/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Obesity is represented mainly by abdominal obesity and insulin resistance (IR), both present in most individuals diagnosed with metabolic syndrome (MS). IR is the key risk factor in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Objective. To relate NAFLD to MS in class III obese individuals. METHODOLOGY A descriptive cross-sectional study with class III obese individuals, aged ≥ 20-60 years. Blood pressure measurement, weight, height, body mass index (BMI), waist circumference (WC) and blood glucose, insulin, high-density lipoprotein cholesterol (HDL-c), and triglycerides data were obtained. HOMA-IR (homeostatic model assessment insulin resistance) calculation was carried out with a cutoff value of 2.71 for IR evaluation. The diagnosis of NAFLD was performed by liver biopsy and the diagnosis of MS was performed in accordance with the National Cholesterol Education Program/Adult Treatment Panel III (NCEPATP III). RESULTS Of the 50 individuals evaluated, 86% were women and BMI means were 45.4 ± 3.6 Kg/m(2). The overall individuals had NAFLD, 70% steatosis, and 30% steatohepatitis. The diagnosis of MS occurred in 56% but showed no significant association with NAFLD (P = 0.254). Triglycerides (178 ± 65.5 mg/dL) and insulin (28.2 ± 22.6 mcU/mL) mean values were significantly higher in steatohepatitis (P = 0.002 and P = 0.042, resp.) compared to individuals with steatosis. IR was confirmed in 76% and showed a relationship with NAFLD severity. CONCLUSION NAFLD was not related to MS; however, MS components, evaluated in isolation, as well as IR, were related to the presence and severity of NAFLD.
Collapse
|