The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis — Systematic Review and Meta-Analysis

Ismaiel, Abdulrahman; Jaaouani, Ayman; Leucuţa, Daniel-Corneliu; Popa, Stefan-Lucian; Dumitraşcu, Dinu Iuliu

doi:10.37766/inplasy2021.12.0056

Cited by 9 publications

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“…Therefore, the disease treatment emphasizes the regulation of metabolism, but from clinical practice, there are still several bottlenecks in NAFLD from diagnosis to treatment [9]. Firstly, in terms of diagnosis, although there are more recognized and mature protocols for monitoring NAFLD in traditional high-risk groups (diabetes, hypertension, overweight), more and more studies have found that NAFLD occurs more frequently in people with normal BMI (i.e., visceral obesity) [49], and for such patients, especially in non-obese people with intermittent transaminase abnormalities, there is still a lack of su ciently effective biological markers for the diagnosis of NAFLD and a lack of effective protocols for predicting the risk of development, as liver aspiration biopsy is still not a common tool, and current guidelines only recommend regular follow-up, which is not conducive to timely treatment [50,51]. Secondly, according to the existing guideline recommendations, lifestyle changes, exercise, and diet control are important non-pharmacological options for people with established NAFLD [52].…”

Section: Discussionmentioning

confidence: 99%

Association between leptin and NAFLD: A Two-Sample Mendelian randomization study

Guo

Chen

Zao

et al. 2022

Preprint

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Background Nonalcoholic fatty liver disease (NAFLD) etiology involves a complex interaction of genetic and environmental factors. Previous observational studies have suggested that increased leptin levels may be associated with a low risk of developing NAFLD, but the causal relationship remains unclear. Due to advances in genome-wide association studies (GWAS) and the discovery of Mendelian randomization (MR), we aimed to investigate the causal effect of leptin and NAFLD using MR analysis. Methods We performed a two-sample Mendelian randomization analysis (TSMR) using summary GWAS data from leptin (up to 50,321 individuals) and NAFLD (894 cases and 217,898 controls) in a European population. Genetic instrumental variables (InstrumentalVariables, IVs) that satisfied the three core assumptions of Mendelian randomization were selected. TSMR analysis was performed using the Inverse Variance Weighted (IVW) method, MR-Egger regression method, and Weighted Median (WM) method. To ensure the accuracy and stability of the study results, heterogeneity tests, multiple validity tests, and sensitivity analyses were conducted. Results The results of TSMR correlation analysis between NAFLD and leptin were IVW (OR: 0.3032; 95% CI 0.1181–0.7783; P = 0.0131), WM method (OR: 0.2816; 95% CI 0.0931–0.8678; P = 0.0273), MR-Egger regression method (P = 0.6955), and Among them, the IVW method and WM method showed P > 0.05, and the results were statistically significant. In addition, TSMR correlation analysis between NAFLD and circulating leptin levels adjusted for Body Mass Index (BMI) resulted in IVW (OR: 0.4416; 95% CI 0.2807–0.6948; P = 0.0004), WM method (OR: 0.4194; 95% CI 0.2279–0.7720; P = 0.0052), MR-Egger regression method (OR: 0.2023; 95% CI 0.0541–0.7562; P = 0.0389), P > 0.05, and the results were statistically significant. It is further demonstrated that increased leptin is causally associated with reduced risk of NAFLD, and leptin may serve as a protective factor for NAFLD. Conclusions In this study, we explored the causal association between leptin and NAFLD from a genetic perspective based on the GWAS database using TSMR analysis. Further studies are needed to explain the underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Association between leptin and NAFLD: A Two-Sample Mendelian randomization study

Guo

Chen

Zao

et al. 2022

Preprint

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“…This systematic review and meta-analysis were written as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement [ 24 ]. The study was registered in INPLASY (International Platform of Registered Systematic Review and Meta-analysis Protocols); registration number (INPLASY2021120056) [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis—Systematic Review and Meta-Analysis

et al. 2021

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(1) Background: In order to avoid a liver biopsy in non-alcoholic fatty liver disease (NAFLD), several noninvasive biomarkers have been studied lately. Therefore, we aimed to evaluate the visceral adiposity index (VAI) in NAFLD and liver fibrosis, in addition to its accuracy in predicting NAFLD and NASH. (2) Methods: We searched PubMed, Embase, Scopus, and Cochrane Library, identifying observational studies assessing the VAI in NAFLD and liver fibrosis. QUADAS-2 was used to evaluate the quality of included studies. The principal summary outcomes were mean difference (MD) and area under the curve (AUC). (3) Results: A total of 24 studies were included in our review. VAI levels were significantly increased in NAFLD (biopsy-proven and ultrasound-diagnosed), simple steatosis vs. controls, and severe steatosis vs. simple steatosis. However, no significant MD was found according to sex, liver fibrosis severity, simple vs. moderate and moderate vs. severe steatosis, pediatric NAFLD, and NASH patients. The VAI predicted NAFLD (AUC 0.767) and NASH (AUC 0.732). (4) Conclusions: The VAI has a predictive value in diagnosing NAFLD and NASH, with significantly increased values in adult NAFLD patients, simple steatosis compared to controls, and severe steatosis compared to simple steatosis.

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“…However, the NAFLD-LFS requires fasting serum insulin, which is not routinely available, hence limiting its clinical utility. Visceral adiposity index (VAI), which uses BMI, waist circumference, and serum triglyceride and high-density lipoprotein (HDL) cholesterol levels, is a surrogate biomarker of visceral adiposity, 16 and a recent systematic review and meta-analysis by Ismaiel et al 17 concluded that VAI has fair accuracy in diagnosing adult NAFLD with an AUROC of 0.77. In a head-to-head comparison with FLI, HSI, and NAFLD-LFS, using liver biopsy as reference standard, VAI performed best in detecting the presence of hepatic steatosis with an AUROC of 0.92.…”

Section: Non-invasive Assessment Of Hepatic Steatosismentioning

confidence: 99%

Non-invasive assessment of metabolic dysfunction–associated fatty liver disease

Kumar

Skantha

Chan

2022

Therapeutic Advances in Endocrinology

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Non-alcoholic fatty liver disease (NAFLD) affects an estimated one-quarter of the global adult population and has become one of the leading causes of end-stage liver disease and hepatocellular carcinoma with increased liver-related and overall morbidity and mortality. The new term, metabolic dysfunction–associated fatty liver disease (MAFLD), has a set of positive diagnostic criteria and has been shown to have better clinical utility, but it has yet to be universally adopted. This review addresses the non-invasive tests for MAFLD and is based mostly on studies on NAFLD patients, as the MAFLD term is relatively new and there are limited studies on non-invasive tests based on this new term, while a large body of research work on non-invasive tests has accumulated in the literature for NAFLD. This review focuses on blood-based biomarkers and scores for the assessment of hepatic steatosis, non-alcoholic steatohepatitis (NASH), and fibrosis, and two of the most widely studied imaging biomarkers, namely vibration-controlled transient elastography and magnetic resonance imaging. Fibrotic NASH has become a diagnostic target of interest and novel serum biomarkers and scores incorporating imaging biomarker for diagnosis of fibrotic NASH are emerging. Nonetheless, the degree of liver fibrosis remains the key predictor of liver-related morbidity and mortality in patients with MAFLD. A multitude of non-invasive biomarkers and scores have been studied for the detection of liver fibrosis, including use of sequential non-invasive tests for risk stratification of advanced liver fibrosis. In addition, this review will explore the utility of the non-invasive tests for prognostication and for monitoring of treatment response.

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The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis — Systematic Review and Meta-Analysis

Cited by 9 publications

References 0 publications

Association between leptin and NAFLD: A Two-Sample Mendelian randomization study

Association between leptin and NAFLD: A Two-Sample Mendelian randomization study

The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis—Systematic Review and Meta-Analysis

Non-invasive assessment of metabolic dysfunction–associated fatty liver disease

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