1
|
Ni J, Huang Y, Xiang Q, Zheng Q, Xu X, Qin Z, Sheng G, Li L. Establishment and Evaluation of a Noninvasive Metabolism-Related Fatty Liver Screening and Dynamic Monitoring Model: Cross-Sectional Study. Interact J Med Res 2024; 13:e56035. [PMID: 39172506 DOI: 10.2196/56035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/03/2024] [Accepted: 07/03/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Metabolically associated fatty liver disease (MAFLD) insidiously affects people's health, and many models have been proposed for the evaluation of liver fibrosis. However, there is still a lack of noninvasive and sensitive models to screen MAFLD in high-risk populations. OBJECTIVE The purpose of this study was to explore a new method for early screening of the public and establish a home-based tool for regular self-assessment and monitoring of MAFLD. METHODS In this cross-sectional study, there were 1758 eligible participants in the training set and 200 eligible participants in the testing set. Routine blood, blood biochemistry, and FibroScan tests were performed, and body composition was analyzed using a body composition instrument. Additionally, we recorded multiple factors including disease-related risk factors, the Forns index score, the hepatic steatosis index (HSI), the triglyceride glucose index, total body water (TBW), body fat mass (BFM), visceral fat area, waist-height ratio (WHtR), and basal metabolic rate. Binary logistic regression analysis was performed to explore the potential anthropometric indicators that have a predictive ability to screen for MAFLD. A new model, named the MAFLD Screening Index (MFSI), was established using binary logistic regression analysis, and BFM, WHtR, and TBW were included. A simple rating table, named the MAFLD Rating Table (MRT), was also established using these indicators. RESULTS The performance of the HSI (area under the curve [AUC]=0.873, specificity=76.8%, sensitivity=81.4%), WHtR (AUC=0.866, specificity=79.8%, sensitivity=80.8%), and BFM (AUC=0.842, specificity=76.9%, sensitivity=76.2%) in discriminating between the MAFLD group and non-fatty liver group was evaluated (P<.001). The AUC of the combined model including WHtR, HSI, and BFM values was 0.900 (specificity=81.8%, sensitivity=85.6%; P<.001). The MFSI was established based on better performance at screening MAFLD patients in the training set (AUC=0.896, specificity=83.8%, sensitivity=82.1%) and was confirmed in the testing set (AUC=0.917, specificity=89.8%, sensitivity=84.4%; P<.001). CONCLUSIONS The novel MFSI model was built using WHtR, BFM, and TBW to screen for early MAFLD. These body parameters can be easily obtained using a body fat scale at home, and the mobile device software can record specific values and perform calculations. MFSI had better performance than other models for early MAFLD screening. The new model showed strong power and stability and shows promise in the area of MAFLD detection and self-assessment. The MRT was a practical tool to assess disease alterations in real time.
Collapse
Affiliation(s)
- Jiali Ni
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yong Huang
- Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, China
| | - Qiangqiang Xiang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Zheng
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiang Xu
- Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, China
| | - Zhiwen Qin
- Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, China
| | - Guoping Sheng
- Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
2
|
Qu B, Li Z. Exploring non-invasive diagnostics for metabolic dysfunction-associated fatty liver disease. World J Gastroenterol 2024; 30:3447-3451. [PMID: 39091712 PMCID: PMC11290396 DOI: 10.3748/wjg.v30.i28.3447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
The population with metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly common worldwide. Identification of people at risk of progression to advanced stages is necessary to timely offer interventions and appropriate care. Liver biopsy is currently considered the gold standard for the diagnosis and staging of MAFLD, but it has associated risks and limitations. This has spurred the exploration of non-invasive diagnostics for MAFLD, especially for steatohepatitis and fibrosis. These non-invasive approaches mostly include biomarkers and algorithms derived from anthropometric measurements, serum tests, imaging or stool metagenome profiling. However, they still need rigorous and widespread clinical validation for the diagnostic performance.
Collapse
Affiliation(s)
- Biao Qu
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zheng Li
- Jiangsu Engineering Research Center of Cardiovascular Drugs Targeting Endothelial Cells, College of Health Sciences, School of Life Sciences, Jiangsu Normal University, Xuzhou 221000, Jiangsu Province, China
| |
Collapse
|
3
|
Trinks J, Mascardi MF, Gadano A, Marciano S. Omics-based biomarkers as useful tools in metabolic dysfunction-associated steatotic liver disease clinical practice: How far are we? World J Gastroenterol 2024; 30:1982-1989. [PMID: 38681130 PMCID: PMC11045490 DOI: 10.3748/wjg.v30.i14.1982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/19/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Unmet needs exist in metabolic dysfunction-associated steatotic liver disease (MASLD) risk stratification. Our ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is still limited. Incorporating novel biomarkers could represent a meaningful improvement to current risk predictors. With this aim, omics technologies have revolutionized the process of MASLD biomarker discovery over the past decades. While the research in this field is thriving, much of the publication has been haphazard, often using single-omics data and specimen sets of convenience, with many identified candidate biomarkers but lacking clinical validation and utility. If we incorporate these biomarkers to direct patients' management, it should be considered that the roadmap for translating a newly discovered omics-based signature to an actual, analytically valid test useful in MASLD clinical practice is rigorous and, therefore, not easily accomplished. This article presents an overview of this area's current state, the conceivable opportunities and challenges of omics-based laboratory diagnostics, and a roadmap for improving MASLD biomarker research.
Collapse
Affiliation(s)
- Julieta Trinks
- Instituto de Medicina Traslacional e Ingeniería Biomédica - Consejo Nacional de Investigaciones Científicas y Técnicas - Instituto Universitario del Hospital Italiano - Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ACL, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - María F Mascardi
- Instituto de Medicina Traslacional e Ingeniería Biomédica - Consejo Nacional de Investigaciones Científicas y Técnicas - Instituto Universitario del Hospital Italiano - Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ACL, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
| | - Adrián Gadano
- Liver Unit, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199DF, Argentina
- Department of Research, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199DF, Argentina
| | - Sebastián Marciano
- Instituto de Medicina Traslacional e Ingeniería Biomédica - Consejo Nacional de Investigaciones Científicas y Técnicas - Instituto Universitario del Hospital Italiano - Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199ACL, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Autónoma de Buenos Aires C1425FQB, Argentina
- Liver Unit, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199DF, Argentina
- Department of Research, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1199DF, Argentina
| |
Collapse
|
4
|
Aydin A, Goktas Aydin S. Associations of serum uric acid levels and anthropometric parameters with non-alcoholic fatty liver disease in healthy individuals: innovative insights from a cross-sectional study. Curr Med Res Opin 2024; 40:209-215. [PMID: 38111962 DOI: 10.1080/03007995.2023.2296967] [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: 08/31/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease (NAFLD is a spectrum of liver disease with a rising prevalence, ranging from simple steatosis to steatohepatitis and cirrhosis, where a significant minority face potential complications. Determining the predictive markers plays a crucial role. This study examined the relationship between serum uric acid (SUA) levels and NAFLD in healthy individuals and identified potential other predictors. MATERIAL AND METHODS A cohort of 2162 healthy participants attending routine check-up visits between February 2021 and May 2023 were included. Participants underwent abdominal ultrasound, uric acid measurements, and anthropometric assessments by TANITA. NAFLD was graded using a "hepatic steatosis score." Statistical analysis included nonparametric tests, chi-squared tests, Fisher's exact test, ROC curve analysis, and logistic regression. RESULTS The median age was 45 years (range:18-65). 1017 were male, and 1145 were female. Among the participants, 53.9%, 26.3%, 17.9%, and 1.9% exhibited Grade 0, 1, 2, and 3 hepatic steatosis, respectively. ROC analysis showed 80.0% sensitivity and 78.8% specificity for detecting grade 2 or higher hepatic steatosis with a cutoff value of 5.21 mg/dl of SUA (AUC = 0.82, p < 0.001, 95%CI 0.79-0.84). There were significant associations between elevated uric acid levels and NAFLD. Participants with higher body fat percentages, BMI values, and waist-to-hip ratios also demonstrated an increased prevalence of steatosis. Gender significantly influenced liver steatosis, with males exhibiting higher grades compared to females. Logistic regression analysis highlighted positive associations between NAFLD and body fat percentage, waist-to-hip ratio, and uric acid levels. Each unit increase in uric acid levels corresponded to a 2.5-fold increase in the odds of NAFLD (p < 0.001, 95% CI = 2.20-2.84). CONCLUSION Our findings suggest a significant relationship between serum uric acid levels and NAFLD in healthy individuals. Elevated uric acid levels, in conjunction with other anthropometric parameters, may serve as potential predictive markers for NAFLD.
Collapse
Affiliation(s)
- Ahmet Aydin
- Medical Faculty, Department of Internal Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Sabin Goktas Aydin
- Medical Faculty, Department of Internal Medicine, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
5
|
Doustmohammadian A, Amirkalali B, Gholizadeh E, Khoonsari M, Faraji AH, Nikkhah M, Maadi M, Motamed N, Mansourian MR, Hajjar M, Clark CCT, Chaibakhsh S, Tameshkel FS, Afzali A, Zamani F. Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study. Eur J Clin Nutr 2023; 77:370-379. [PMID: 36443393 DOI: 10.1038/s41430-022-01240-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 10/31/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM). METHODS A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols. RESULTS DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P < 0.0001, and of WC to NAFLD: β = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (β = -0.06, P = 0.001, β = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (β = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ2/df = 4.72, GFI = 0.98, AGFI = 0.97, IFI = 0.95, CFI = 0.95, RMSEA = 0.03, and SRMR = 0.02). CONCLUSION Meat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.
Collapse
Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Amirkalali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeel Gholizadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoodreza Khoonsari
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Faraji
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Nikkhah
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Reza Mansourian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Melika Hajjar
- Student Research Committee (National Nutrition and Food Technology Research Institute, Department of Community Nutrition, School of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Samira Chaibakhsh
- Eye Reasearch Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Arian Afzali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
6
|
Lu Y, Ge L, Yang H, He Y, Wang Y. Chinese Visceral Adipose Index Shows Superior Diagnostic Performance in Predicting the Risk of Metabolic Dysfunction Associated Fatty Liver Disease in Early Postmenopausal Chinese Women. Diabetes Metab Syndr Obes 2023; 16:607-617. [PMID: 36909348 PMCID: PMC9999715 DOI: 10.2147/dmso.s402814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Previous studies have reported the diagnostic values of multiple obesity indicators for predicting the risk of non-alcoholic fatty liver disease. However, the diagnostic values of obesity indicators for predicting the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in early postmenopausal women is still unknown. Therefore, this study investigated the predictive values of common obesity indices for estimating the risk of MAFLD in early postmenopausal Chinese women. METHODS This study enrolled 2514 early postmenopausal women, aged between 45 and 55 years, who underwent abdominal ultrasonography examination at the Health examination center of the Huadong Sanatorium between June 2021 and December 2021. The values for six obesity indices, namely, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and Chinese visceral adiposity index (CVAI) were extracted from the medical records. RESULTS Our data showed that all the six obesity indices were significantly associated with the risk of MAFLD (P < 0.05) in the obese subjects and five obesity indices except for BAI were significantly associated with the risk of MAFLD (P < 0.05) in the lean subjects. The six obesity indices showed a linear relationship with the risk of MAFLD (all P-values > 0.05). The ORs for the obesity indices with the exception of BAI showed proportional increase with the risk of MAFLD in the lean subjects. CVAI was the strongest predictor of the risk of MAFLD in both lean (AUC=0.868) and overweight/obese subjects (AUC=0.704) among the early postmenopausal women. CONCLUSION This study demonstrated that all the obesity indices were associated with an increased risk of MAFLD in the obese subjects and five obesity indices except for BAI were associated with an increased risk of MAFLD in the lean subjects among the early postmenopausal women. CVAI showed the strongest predictive performance in estimating the risk of MAFLD among early menopausal women.
Collapse
Affiliation(s)
- Yayun Lu
- Health Examination Center, Huadong Sanatorium, Wuxi, People’s Republic of China
| | - Lingxia Ge
- Health Examination Center, Huadong Sanatorium, Wuxi, People’s Republic of China
| | - Hao Yang
- Department of Stomatology, Huadong Sanatorium, Wuxi, People’s Republic of China
| | - Yufeng He
- Department of Stomatology, Huadong Sanatorium, Wuxi, People’s Republic of China
| | - Yujun Wang
- Department of health Nursing, Huadong Sanatorium, Wuxi, People’s Republic of China
- Correspondence: Yujun Wang, Department of health nursing, Huadong Sanatorium, Wuxi, No. 67 Jinyuan Road, People’s Republic of China, Tel +86 13912359439, Email
| |
Collapse
|
7
|
Danielsson O, Nano J, Pahkala K, Rospleszcz S, Lehtimäki T, Schlett CL, Kähönen M, Bamberg F, Raitakari O, Peters A, Nissinen MJ, Åberg FO. Validity of fatty liver disease indices in the presence of alcohol consumption. Scand J Gastroenterol 2022; 57:1349-1360. [PMID: 35723012 DOI: 10.1080/00365521.2022.2085060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease frequently coexist. While several blood-based indices exist for the detection of NAFLD, few studies have examined how alcohol use possibly impacts their diagnostic performance. We analysed the effects of alcohol use on the performance of indices for detecting fatty liver disease (FLD). METHODS We included participants from the Cardiovascular Risk in Young Finns Study (Finnish sample) and KORA study (German sample) who underwent abdominal ultrasound or magnetic resonance imaging, respectively, for detection of FLD and had serum analyses available for calculation of Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Lipid Accumulation Product (LAP), and Dallas Steatosis Index (DSI). Alcohol use was estimated by questionnaires as mean daily consumption and binge drinking (Finnish sample only). Predictive performance for FLD was assessed according to alcohol consumption. RESULTS The study included 1426 (Finnish sample) and 385 (German sample) individuals, of which 234 (16%) and 168 (44%) had FLD by imaging. When alcohol consumption was <50 g/day, all indices discriminated FLD with area under the receiver operating characteristics (AUROC) of 0.82-0.88. AUROCs were 0.61-0.66 among heavy drinkers (>50 g/day). AUROCs decreased to 0.74-0.80 in the highest binge-drinking category (>2 times/week). Alcohol use correlated with FLI and LAP (r-range 0.09-0.16, p-range <.001-.02) in both samples and with DSI (r = 0.13, p < .001) in the Finnish sample. CONCLUSIONS Indices perform well and comparably for detection of FLD with alcohol consumption <50 g/day and with different binge-drinking behaviour.
Collapse
Affiliation(s)
- Oscar Danielsson
- Clinic of Gastroenterology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jana Nano
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), partner site Neuherberg, Neuherberg, Germany
| | - Katja Pahkala
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Ltd, Tampere, Finland.,Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), partner site Neuherberg, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markku J Nissinen
- Clinic of Gastroenterology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Fredrik O Åberg
- Transplantation and Liver Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
8
|
Perez-Diaz-Del-Campo N, Martínez-Urbistondo D, Bugianesi E, Martínez JA. Diagnostic scores and scales for appraising Nonalcoholic fatty liver disease and omics perspectives for precision medicine. Curr Opin Clin Nutr Metab Care 2022; 25:285-291. [PMID: 35788123 DOI: 10.1097/mco.0000000000000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Nonalcoholic fatty liver disease (NAFLD) is a rising epidemic burden affecting around 25% of the global population. Liver biopsy remains the reference for NAFLD. However, the application of several scales and clinical algorithms have been proposed to diagnose NAFLD using prediction questions and blood biomarkers. This review presents a summarized of the currently available and emerging diagnostic biomarkers and scores used to assess NAFLD. RECENT FINDINGS The limitations of liver biopsy have fostered the development of alternative noninvasive strategies, which have been an area of intensive investigation over the past years. Diagnostic scores for NAFLD have shown to be a good alternative for disease diagnosis and prognosis due to a suitable applicability, good inter-laboratory reproducibility and widespread potential availability with reasonable costs. SUMMARY The growing NAFLD pandemic urges clinicians to seek alternatives for screening, early diagnosis, and follow-up, especially for those with contraindications for liver biopsy. New promising noninvasive biomarkers and techniques have been developed, evaluated and assessed, including diagnostic biomarkers scores. Moreover, multiomics markers panels involving phenotype, genotype, microbiome and clinical characteristics from patients will facilitate the diagnosis, stratification and prognosis of NAFLD patients with precision medicine approaches.
Collapse
Affiliation(s)
| | | | | | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red de La Fisiopatología de La Obesidad Y Nutrición (CIBERobn), Carlos III Health Institute
- Madrid Institute of Advanced Studies (IMDEA Food), Food Institute, Madrid, Spain
| |
Collapse
|
9
|
Correa-Rodríguez M, Izquierdo M, García-Hermoso A, Ramírez-Vélez R. Discriminatory capacity of obesity indicators as predictors of high liver fat in US adolescents. Eur J Clin Invest 2022; 52:e13654. [PMID: 34293184 DOI: 10.1111/eci.13654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/14/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aims of this study were to assess the potential of 16 anthropometric, body composition and endocrine indexes as predictors of high liver fat and determine the most appropriate cut-off points in US adolescents. METHODS A cross-sectional study was conducted on a population of 816 adolescents aged 12-17 years. The FibroScan® 502V2 device was used to estimate the controlled attenuation parameter (CAP). Body fat percentage, fat mass, trunk fat percentage and trunk fat mass were measured by dual-energy X-ray absorptiometry. Anthropometric data and metabolic parameters were determined. Receiver operating characteristic curves were analysed to estimate the optimal cut-off points that best identify adolescents with high liver fat (CAP ≥90th percentile). RESULTS In boys, triponderal mass index (TMI) had the highest area under curve (AUC) value (0.865) and the optimal cut-off score for TMI was 17.47 kg/m3 , which had 81.32 sensitivity and 82.99 specificity. In girls, trunk fat index (TFI) had the highest AUC value (0.826) and its optimal cut-off score in screening for high liver fat was 3.76 kg/m2 , which had 74.04 sensitivity and 88.03 specificity. Fat mass index (FMI) index had the second highest AUC values (0.863 in boys 0.812 in girls) in both sex; the cut-off point for the detection of high liver fat was <8.66 kg/m2 for girls and <7.45 kg/m2 for boys. CONCLUSION Assessment of TMI in boys, TFI in girls, and FMI in both sexes are low-cost and easy-to-use parameters that may be useful as early screening tools for possible high liver fat in adolescents.
Collapse
Affiliation(s)
- María Correa-Rodríguez
- Departament of Nursing, Health Sciences Faculty, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Institute of Health Carlos III, Madrid, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Spain.,Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Institute of Health Carlos III, Madrid, Spain
| |
Collapse
|
10
|
Cai J, Lin C, Lai S, Liu Y, Liang M, Qin Y, Liang X, Tan A, Gao Y, Lu Z, Wu C, Huang S, Yang X, Zhang H, Kuang J, Mo Z. Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population. Lipids Health Dis 2021; 20:145. [PMID: 34706716 PMCID: PMC8549212 DOI: 10.1186/s12944-021-01568-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Therefore anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. This study intended to validate and compare the MAFLD predictive and diagnostic capability of eight anthropometric indicators. Methods The study involved a population-based retrospective cross-sectional design. The Fangchenggang area male health and examination survey (FAMHES) was used to collect data of eight anthropometric indicators, involving body mass index (BMI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and abdominal volume index (AVI). Receiver operating characteristics (ROC) curves and the respective areas under the curves (AUCs) were utilized to compare the diagnostic capacity of each indicator for MAFLD and to determine the optimal cutoff points. Binary logistic regression analysis was applied to identify the odds ratios (OR) with 95% confidence intervals (95% CI) for all anthropometric indicators and MAFLD. The Spearman rank correlation coefficients of anthropometric indicators, sex hormones, and MAFLD were also calculated. Results All selected anthropometric indicators were significantly associated with MAFLD (P < 0.001), with an AUC above 0.79. LAP had the highest AUC [0.868 (95% CI, 0.853–0.883)], followed by WHtR [0.863 (95% CI, 0.848–0.879)] and AVI [0.859 (95% CI, 0.843–0.874)]. The cutoff values for WHtR, LAP and AVI were 0.49, 24.29, and 13.61, respectively. WHtR [OR 22.181 (95% CI, 16.216–30.340)] had the strongest association with MAFLD, regardless of potential confounders. Among all the anthropometric indicators, the strongest association was seen between LAP and sex hormones. Conclusion All anthropometric indicators were associated with MAFLD. WHtR was identified as the strongest predictor of MAFLD in young Chinese males, followed by LAP and AVI. The strongest association was found between LAP and sex hormones. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01568-9.
Collapse
Affiliation(s)
- Jinwei Cai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Cuiting Lin
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yingshan Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Min Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xinghuan Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Aihua Tan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yong Gao
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zheng Lu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Chunlei Wu
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shengzhu Huang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian Kuang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
11
|
Wu Q, Qin K, Wang Y, Nie H. Anthropometric indices and their predictive ability on metabolic syndrome in west China. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
12
|
Bence KK, Birnbaum MJ. Metabolic drivers of non-alcoholic fatty liver disease. Mol Metab 2021; 50:101143. [PMID: 33346069 PMCID: PMC8324696 DOI: 10.1016/j.molmet.2020.101143] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/02/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The incidence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide parallel to the global obesity epidemic. NAFLD encompasses a range of liver pathologies and most often originates from metabolically driven accumulation of fat in the liver, or non-alcoholic fatty liver (NAFL). In a subset of NAFL patients, the disease can progress to non-alcoholic steatohepatitis (NASH), which is a more severe form of liver disease characterized by hepatocyte injury, inflammation, and fibrosis. Significant progress has been made over the past decade in our understanding of NASH pathogenesis, but gaps remain in our mechanistic knowledge of the precise metabolic triggers for disease worsening. SCOPE OF REVIEW The transition from NAFL to NASH likely involves a complex constellation of multiple factors intrinsic and extrinsic to the liver. This review focuses on early metabolic events in the establishment of NAFL and initial stages of NASH. We discuss the association of NAFL with obesity as well as the role of adipose tissue in disease progression and highlight early metabolic drivers implicated in the pathological transition from hepatic fat accumulation to steatohepatitis. MAJOR CONCLUSIONS The close association of NAFL with features of metabolic syndrome highlight plausible mechanistic roles for adipose tissue health and the release of lipotoxic lipids, hepatic de novo lipogenesis (DNL), and disruption of the intestinal barrier in not only the initial establishment of hepatic steatosis, but also in mediating disease progression. Human genetic variants linked to NASH risk to date are heavily biased toward genes involved in the regulation of lipid metabolism, providing compelling support for the hypothesis that NASH is fundamentally a metabolic disease.
Collapse
Affiliation(s)
- Kendra K Bence
- Internal Medicine Research Unit, Pfizer Worldwide Research, Development, and Medical, Cambridge, MA, USA.
| | - Morris J Birnbaum
- Internal Medicine Research Unit, Pfizer Worldwide Research, Development, and Medical, Cambridge, MA, USA
| |
Collapse
|
13
|
Hasan EM, Abd Al Aziz RA, Sabry D, Badary HA, Gaber Y, Yosry A, Zakaria Z. The association of adiponectin gene polymorphisms with susceptibility and progression of NAFLD in a cohort of Egyptian patients. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00103-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Background
Several genetic polymorphisms have been proven to play a key role in the progression of non-alcoholic fatty liver disease (NAFLD) from simple steatosis to NASH with fibrosis. Our aim was to study the effect of single nucleotide polymorphisms (SNPs) in the adiponectin gene, namely rs266729 and rs3774261, on susceptibility to NAFLD and disease progression.
Results
There was a definitive association between polymorphisms of the studied SNPs and NAFLD. Among rs266729, CG was significantly higher among patients than controls showing increased risk for NAFLD (P<0.05). AA genotype of the rs3774261 variant was significantly lower in patients than in controls (P value< 0.001) while AG and GG genotypes were significantly higher in patients than in controls (P value<0.05); A allele was significantly higher among controls (P=0.019) which might have a protective effect. None of the variants correlated significantly with the degree of steatosis. Using multivariate regression analysis, there was no significant correlation with any of the independent risk factors to the degree of steatosis.
Conclusions
There was an association between polymorphisms of the studied SNPs of rs266729 and rs3774261 of the adiponectin gene and NAFLD.
Collapse
|
14
|
Song SH, Wong YC, Wu TC, Huang CF. Pediatric non-alcoholic fatty liver disease predicted by anthropometric values through transient elastography. Pediatr Int 2021; 63:183-188. [PMID: 32687673 DOI: 10.1111/ped.14395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/10/2020] [Accepted: 07/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the leading cause of pediatric chronic liver disease, which is strongly associated with obesity. Transient elastography, together with anthropometric values including waist-to-height ratio (WHtR) and body mass index (BMI) z-scores are a more precise diagnostic method of NAFLD than ultrasonography. Through transient elastography, we investigate the principal anthropometric values associated with pediatric NAFLD. METHODS Healthy children between the ages of 6-18 years whose BMIs were ≥85% of normal were recruited as the overweight-and-obese group, and children whose BMIs ranged between 5%-85% were recruited as the control group. Non-alcoholic fatty liver disease was evaluated via transient elastography. BMI z-score and WHtR were measured. RESULTS A total of 107 (58 overweight-and-obese, 49 control) children were recruited. As evaluated by transient elastography, children in the overweight-and-obese group had significantly higher controlled attenuation parameter and liver stiffness measurement values than the control group. To detect fatty liver, WHtR with a cut-off point of 0.481 and BMI z-score with cut-off point of 1.075 had the best sensitivity and specificity. To identify liver stiffness or inflammation, WHtR with cut-off point of 0.514 and BMI z-score with cut-off point of 1.62 had the best sensitivity and specificity. Controlled attenuation parameter demonstrated a fair correlation with WHtR and BMI z-scores, even in the normal range of these parameters. CONCLUSIONS Transient elastography together with anthropometric measurements demonstrate that pediatric NAFLD may develop earlier than expected. We present principal anthropometric values associated with pediatric NAFLD.
Collapse
Affiliation(s)
- Shih-Hsi Song
- Department of Pediatrics, National Yang Ming University Hospital, Yilan, Taiwan.,School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Ying-Chi Wong
- School of Medicine, National Yang Ming University, Taipei, Taiwan.,Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzee-Chung Wu
- School of Medicine, National Yang Ming University, Taipei, Taiwan.,Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Feng Huang
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
15
|
Comparison of anthropometric indices for the screening of nonalcoholic fatty liver disease in pre- and postmenopausal women. ACTA ACUST UNITED AC 2021; 27:88-94. [PMID: 31613826 DOI: 10.1097/gme.0000000000001419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Although it has been well-established that menopause causes a shift in body fat, there has been no study conducted yet to examine the best obesity parameters to predict the risk of nonalcoholic fatty liver disease (NAFLD) in this population. Thus, the aim of this study was to clarify the superiority among various obesity indices such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for predicting NAFLD in pre- and postmenopausal women. METHODS This cross-sectional analysis included 620 healthy women (318 premenopausal and 302 postmenopausal women) between 20 and 80 years of age recruited from the Health Promotion Center of Korea University Guro Hospital. NAFLD was diagnosed by abdominal ultrasonography. RESULTS In premenopausal women, there were no statistical differences in the area under the curve values among the three obesity indices, whereas, in postmenopausal women, the area under the curve value of WHR was significantly larger than those of either BMI (difference between area: 0.102, 95% confidence interval: 0.031, 0.173) or WC (difference between area: 0.064, 95% confidence interval: 0.018-0.109). Furthermore, in postmenopausal women, the combination of WHR with BMI or WC significantly increased predictive power of NAFLD when compared to using BMI or WC alone. The optimal cutoff values for BMI, WC, and WHR for detecting NAFLD were 23.9 kg/m, 69 cm, and 0.81 in premenopausal women and 22.9 kg/m, 74 cm, and 0.86 in postmenopausal women, respectively. CONCLUSIONS In premenopausal women, BMI, WC, and WHR hold similar potential in predicting the risk of NAFLD, whereas, in postmenopausal women, WHR is the most useful discriminative indicator for NAFLD. Women's optimal cutoff values for NAFLD were different according to menopausal status.
Collapse
|
16
|
Anoop S, Krakauer J, Krakauer N, Misra A. A Body shape index significantly predicts MRI-defined abdominal adipose tissue depots in non-obese Asian Indians with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2020; 8:8/1/e001324. [PMID: 33051279 PMCID: PMC7554502 DOI: 10.1136/bmjdrc-2020-001324] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION We aimed to determine the correlations of volumes of subcutaneous abdominal adipose tissue (SCAT) (anterior, posterior, superficial and deep), total SCAT, intraperitoneal adipose tissue, retroperitoneal abdominal adipose tissue (RPAT), total intra-abdominal adipose tissue (IAAT), pancreatic volume, liver span, total body fat (TBF) and truncal fat mass (TFM) with anthropometric indices, viz., A Body Shape Index (ABSI), Hip Index, their Z scores and Anthropometric Risk Index in non-obese (body mass index (BMI) <25 kg/m2) Asian Indians with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Non-obese patients with T2DM (cases; n, 85) and BMI-matched, healthy subjects (controls; n, 38) underwent anthropometry, dual energy X ray absorptiometry (DXA) for estimation of TBF, TFM and 1.5 T MRI for estimation of volumes of abdominal adipose tissue depots, pancreas and liver span. Spearman's correlation analysis and Receiver Operator Characteristic curve analysis were applied. RESULTS The Z score of ABSI (Z_ABSI) showed significantly positive correlation with volumes of all depots of abdominal SCAT, total IAAT and RPAT in cases. Area under the curve for Z_ABSI (0.87) showed higher sensitivity: 82.0 %, specificity: 81.5 %, at a predictive cut-off value of 0.49 for abdominal adiposity. CONCLUSION In non-obese Asian Indians with T2DM, the Z_ABSI showed significant correlation with IAAT and SCAT and higher predictive accuracy for abdominal adiposity. HIGHLIGHTS OF THE STUDY This is the first MRI-based study in the context of ABSI in non-obese (BMI <25 kg/m2) Asian Indians with T2DM. Findings indicate that Z_ABSI has high predictive accuracy for abdominal adiposity in non-obese Asian Indians. The Z_ABSI index showed significantly positive correlation with volumes of adipose tissue depots, viz., abdominal SCAT, total IAAT and RPAT in cases.
Collapse
Affiliation(s)
- Shajith Anoop
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), Safdarjung Development Area, New Delhi, India
- Diabetes Foundation (India), Safdarjung Development Area, New Delhi, India
- Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Fortis C-DOC Hospital, New Delhi, India
- National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India
| | - Jesse Krakauer
- Metro Detroit Diabetes and Endocrinology, Southfield, Michigan, USA
| | - Nir Krakauer
- Department of Civil Engineering, The City College of New York, New York, New York, USA
| | - Anoop Misra
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), Safdarjung Development Area, New Delhi, India
- Diabetes Foundation (India), Safdarjung Development Area, New Delhi, India
- Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Fortis C-DOC Hospital, New Delhi, India
- National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India
| |
Collapse
|
17
|
Li C, Chou Y, Shen W, Lu F, Yang Y, Wu J, Chang C. Increased risks of different grades of non-alcoholic fatty liver disease in prediabetic subjects with impaired fasting glucose and glucose tolerance, including the isolated glycosylated hemoglobin levels of 5.7-6.4% in a Chinese population. J Diabetes Investig 2020; 11:1336-1343. [PMID: 32270583 PMCID: PMC7477498 DOI: 10.1111/jdi.13268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/05/2020] [Accepted: 03/24/2020] [Indexed: 12/16/2022] Open
Abstract
AIMS/INTRODUCTION Contrary to the results of the majority of studies on diabetes, there are some conflicting results regarding the relationship between non-alcoholic fatty liver disease (NAFLD) and prediabetes. No study has investigated the relationship between isolated glycated hemoglobin (HbA1c) in the range of 5.7-6.4% (HbA1c 5.7-6.4%) and NAFLD. Our aim was to investigate the effect of different glycemic statuses on NAFLD concomitantly categorized by fasting plasma glucose, 2-h plasma glucose and HbA1c levels. MATERIALS AND METHODS NAFLD was classified into three groups by ultrasonographic examination results: normal, mild and moderate-to-severe. Glycemic status was divided into five groups: normoglycemia, isolated HbA1c 5.7-6.4%, impaired fasting glucose without impaired glucose tolerance (IGT), IGT and newly diagnosed diabetes. For multivariable logistic regression analyses, the outcome variable was the classified three grades of fatty changes in the liver after adjusting for other potential risk covariables. RESULTS In this cross-sectional research, a total of 8,571 eligible individuals were enrolled and divided into three groups: 5,499 without fatty liver, 2,113 with mild NAFLD and 959 with moderate-to-severe NAFLD. Multivariable logistic regression analysis showed that IGT, impaired fasting glucose without IGT and isolated HbA1c 5.7-6.4% were associated with a higher risk of NAFLD in addition to newly diagnosed diabetes. Other positively predictive variables were male sex, obesity, overweight, central obesity, increased triglyceride and C-reactive protein >1 mg/L. Negatively associated factors were elevated high-density lipoprotein cholesterol levels. CONCLUSIONS Besides diabetes, the increased risks of different grades of NAFLD were found for prediabetic individuals categorized by impaired fasting glucose without IGT, IGT and isolated HbA1c 5.7-6.4%.
Collapse
Affiliation(s)
- Chung‐Hao Li
- Department of Health Management CenterNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Yu‐Tsung Chou
- Department of Health Management CenterNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Wei‐Chen Shen
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Feng‐Hwa Lu
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Geriatrics and GerontologyNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Yi‐Ching Yang
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Jin‐Shang Wu
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineNational Cheng Kung University HospitalDou-Liou BranchCollege of MedicineNational Cheng Kung UniversityYunlinTaiwan
| | - Chih‐Jen Chang
- Department of Family MedicineNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of Family MedicineDitmanson Medical Foundation Chia-yi Christian HospitalChiayiTaiwan
| |
Collapse
|