Association of calf circumference with insulin resistance and non-alcohol fatty liver disease: the REACTION study

Abstract

BackgroundThe feature of nonalcoholic fatty liver disease (NAFLD) is pathological excessive liver lipid accumulation of subjects who without history of alcohol abuse. Calf circumference is a proxy for lower-body fat and screening method for the identification of subjects with acatastatic lipid accumulation. The objective of this study was to examine the association between calf circumference and NAFLD.MethodsThe study was a cross-sectional analysis including 8850 middle-aged and elderly individuals. NAFLD was examined by hepatic ultrasound and without alcohol abuse and other liver diseases. Calf circumference was measured on the lower right leg at the point of maximal circumference.ResultsThe mean of calf circumference were 35.7 cm for male and 34.6 cm for female (P < 0.001), respectively. Compared with the lowest calf circumference quartile, the odds ratio for NAFLD in the highest quartile was 2.73 (95% CI 2.34-3.19, P trend <0.001) after adjusted for potential cofounders. There were also significant positive correlation between calf circumference and HOMA-IR, liver enzyme levels and triglycerides. In addition, we found significant positive correlation of calf circumference with the HOMA-IR and fasting insulin level in overweight and obese subjects (BMI ≥ 24 kg/m2) but not in lean subjects (test for interaction: P both less than 0.001 for insulin and HOMA-IR).ConclusionHigh calf circumference is significantly associated with elevated prevalence of NAFLD and increasing insulin resistance.

Investigating the Relationship Between Insulin Resistance and Fatty Liver in a Random Population of Tehran

“…Thus, this factor might increase the risk of NAFLD and justify our results. Contrary to the results of previous studies on the significant effect of 2-h glucose on NAFLD (38), this study failed to show a statistically significant relationship between 2-h glucose and NAFLD. The possible reason for this finding could be the small number of subjects with abnormal 2-h glucose in this study.…”

Incidence of Muscular Strength, Anthropometry, and Asymmetry in the General Index of Autonomy in Older Chilean Women

“…These results are consistent with the evidence in the current literature, since it has been shown that calf circumference tends to decrease as age advances (Gonzalez et al, 2021). In fact, evidence has shown that conditions such as sarcopenia, disability, and chronic noncommunicable diseases have a close relationship with calf circumference (Zhang et al, 2017). Furthermore, this parameter could predict nutritional risks, frailty, and predict mortality in the older adults (Wei et al, 2022) In summary, the monitoring and control of some anthropometric parameters such as the measurement of the circumferences of the limbs, is a simple, practical, and important way of evaluating the health of the older adults in the community context.…”

Epidemiological trends and clinical characteristic of NAFLD/MAFLD in Asia

“…The Global NAFLD Registry data on clinical and patient‐reported outcomes showed that NAFLD patients in South Asia were the youngest, and had the highest employment rates and the lowest rates of MetS 6 . Calf circumference, neck circumference, chronic kidney disease, and impaired lung function were found to be associated with NAFLD in our community‐based study in adults in Shanghai, China 7–10 …”

“…6 Calf circumference, neck circumference, chronic kidney disease, and impaired lung function were found to be associated with NAFLD in our community-based study in adults in Shanghai, China. [7][8][9][10] According to the GO ASIA initiative study, the percentages of NASH and advanced fibrosis were 62.9% and 17.2% among 1008 patients with biopsy-proven NAFLD. 11 The proportion of advanced fibrosis in patients with NASH was higher than that in those with SFL (20.7% vs 11.2%).…”