Regional body fat distribution may represent an independent risk factor for several conditions, especially metabolic and cardiovascular diseases; recent findings have shown that abdominal fat accumulation can be an independent predictor of hepatic steatosis. Very few studies, mostly using selected clinical samples, have focused on the relationship between indices of abdominal visceral fat accumulation and the most commonly used biochemical liver tests, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). The aim of the present study was to evaluate the relation between central fat accumulation, as assessed by abdominal height, relative weight, as determined by body mass index (BMI), and liver function tests (ALT, AST, and GGT) in a random sample of 2,704 residents of Erie and Niagara Counties in New York State, 35-80 years of age and free from known hepatic disease. Multiple linear regression models were used, with liver enzymes as dependent variables with abdominal height and BMI as independent variables, and the inclusion of several covariates (age, race, education, smoking status, pack-years of smoking, drinking status, and total ounces of ethanol in the past 30 days). Abdominal height was consistently a better correlate of ALT and GGT levels than BMI in both sexes. In addition, abdominal height was the most powerful independent predictor of ALT in both sexes as well as of GGT among women. In conclusion, these findings support a role for central adiposity independent from BMI in predicting increased levels of hepatic enzymes, likely as a result of unrecognized fatty liver. (HEPATOLOGY 2004;39:754 -763.) O besity is an important predictor of several diseases, 1 as well as one of the risk factors most frequently associated with increased liver enzymes. [2][3][4][5][6][7] In the last several years, many epidemiological studies strongly indicated that regional body fat distribution, with abdominal accumulation, irrespective of total body fat quantity, as assessed by body mass index (BMI), may represent a major independent risk factor for several conditions, especially metabolic and cardiovascular diseases. 8,9 Furthermore, recent findings have shown that central adiposity can be an independent predictor of hepatic steatosis (fatty liver), 10,11 a common clinical and histological condition frequently associated with alcohol consumption and excessive body weight. In addition, obesity seems to represent a better predictor of fatty liver than heavy drinking and the coexistence of both conditions (obesity and heavy drinking) may produce a very high risk of developing this condition. 12 Increased levels primarily of alanine aminotransferase (ALT) and triglycerides, and secondarily of gamma-glutamyltransferase (GGT), appear to be the most sensitive biochemical indicators of the presence of hepatic steatosis. 11,12 Despite the growing body of evidence on the importance of visceral adiposity and the independent role of weight with respect to alcohol consumption ...

The ACE I/D polymorphism was a significant predictor of overweight and abdominal adiposity in men. DD homozygosity was associated with larger increases in body weight and blood pressure in aging persons, as well as with higher incidence of overweight.

Relationships between self-reported psychological distress (Symptom Checklist) and experience with two earthquakes are presented for a group of male factor workers (N = 772) from Naples, Italy, participating in the 1987 follow-up of the Olivetti Heart Study. Although all were exposed to the 1980 earthquake that racked southern Italy, only men residing in the Naples suburb of Pozzuoli experienced the continuing swarm of earthquakes ("bradyseism") of 1983-1984, allowing for the observation of a "natural experiment" of sorts. Levels of psychological distress were found to be higher 7 years after the first earthquake for those men who reported damage from that earthquake. Overall, findings were similar for those who were evacuated, or suffered financial loss from the 1983-1984 bradyseism earthquakes. Stratification by 1980 earthquake damage revealed that 1983-1984 evacuation or financial loss was associated with increased distress reporting only for those men who had not reported damage from the 1980 earthquake. Overall, however, distress scores tended to be higher for men evacuated in 1983-1984 if they had also reported damage from the prior earthquake (only the F ratio for anxiety reached criterion for statistical significance). These findings suggest that the psychological consequences of earthquake exposure are long lasting and seem to be related to the consequences of the earthquake in terms of damage/loss.