Visceral fat area to appendicular muscle mass ratio as a predictor for nonalcoholic fatty liver disease independent of obesity

Shi, Yimin; Chen, Xiangyu; Qiu, Hui-Na; Jiang, Wei-Ran; Zhang, Minying; Huang, Ya‐Ping; Ji, Yun-Ping; Shi, Z.; Li, Chunjun; Lin, Jin Ding

doi:10.1080/00365521.2021.1879244

Cited by 13 publications

(9 citation statements)

References 39 publications

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“…In a study in Taiwan, the ideal cutoff for VFA to predict NAFLD was 70.5 cm 2 [ 33 ]. In another study, the ideal cutoffs for VAR predicted NAFLD to be 3.469 for men and 6.357 for women in Tianjin [ 38 ]. Studies have demonstrated that decreased muscle mass and increased visceral fat exacerbate the increased risk of NAFLD in Japan [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China

Yang

et al. 2022

Lipids Health Dis

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Background Since the discovery of metabolic-associated fatty liver disease (MAFLD) in 2020, no report on the connection between the visceral fat area (VFA) and MAFLD has been published in China, and the ideal cutoffs of VFA for predicting MAFLD has not been determined so far. Thus, the purpose of this research was to clarify the relationship between VFA and MAFLD and the ideal cutoffs of VFA to predict MAFLD in the Chinese population. Methods Five thousand three hundred forty subjects were included in this research, with 30% randomly selected for the validation set (n = 1602) and 70% for the Training set (n = 3738). The association between VFA and MAFLD was determined by multiple logistic regression. ROC curves were used to evaluate the prediction effect of VFA on MAFLD. Results Multiple logistic regression analysis revealed that the VFA ORs (95% CIs) were 1.25 (1.20, 1.29) for women and 1.15 (1.12, 1.17) for men. Meanwhile, the VFA quartile OR (95% CI) were 3.07 (1.64, 5.75), 7.22 (3.97, 13.14), 18.91 (10.30, 34.71) for women and 3.07 (1.64, 5.75), 7.22 (3.97, 13.14),18.91 (10.30, 34.71) for men in the Q2, Q3, and Q4 groups compared with Q1. The ROC curve showed the VFA, WC, WHR, and WHtR to predict MAFLD, the AUC value of VFA was the highest and the prediction effect was the best. The ideal cutoffs of VFA to predict MAFLD was 115.55 cm2 for women and 178.35 cm2 for men, and the AUC was 0.788 and 0.795, respectively. Finally, the AUC was 0.773 for women and 0.800 for men in the validation set. Conclusion VFA was an independent predictive factor for MAFLD, and the ideal cutoff of VFA to predict MAFLD was 115.55 cm2 in women and 178.35 cm2 in men.

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Section: Discussionmentioning

confidence: 99%

Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China

Yang

et al. 2022

Lipids Health Dis

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“…According to our knowledge, this is the largest and first research to date that has investigated the impact of sex on the association of SVR as well as disease severity of liver for patients having NAFLD. Over the past few years, the relationship between decreasing SVR and presence of cardiometabolic diseases (including NAFLD) has attracted increasing scientific interest (8,16,17,18,26) . However, no unified conclusion has been reached mainly due to different diagnostic methods of NAFLD and sarcopenic obesity.…”

Section: Discussionmentioning

confidence: 99%

Sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio and non-alcoholic steatohepatitis in patients with biopsy-proven non-alcoholic fatty liver disease

Wang

et al. 2021

Br J Nutr

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Background: Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), i.e., an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. Methods: SVR was measured by bioelectrical impedance in a cohort of 613(M/F=443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression as well as subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e., nonalcoholic steatohepatitis (NASH) or NASH with presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score≥5, with a minimum score of 1 for each of its categories. Presence of fibrosis was classified as having a histological stage ≥1. Results: SVR was inversely associated with NASH in men (adjusted-odds ratio 0.62; 95%CI 0.42-0.92, P=0.017 for NASH, adjusted-odds ratio 0.65; 95%CI 0.43-0.99, P=0.043 for NASH with presence of fibrosis); but not in women 1.47 (0.76, 2.83), P=0.25 for NASH, and 1.45 (0.74, 2.83), P=0.28 for NASH with presence of fibrosis. There was a significant interaction for sex and SVR (P interaction =0.017 for NASH and P interaction =0.033 for NASH with presence of fibrosis). Conclusion: Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.

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“…19 VFA was measured within 1 day of liver biopsy. A bioelectrical impedance analyzer (BIA) (InBody 720; Biospace, Seoul, South Korea) was 20,21 The aforementioned laboratory and anthropometric variables were collected for all participants within 1 day of liver biopsy examinations.…”

Section: Laboratory and Clinical Datamentioning

confidence: 99%

PNPLA3 rs738409 C>G Variant Influences the Association Between Visceral Fat and Significant Fibrosis in Biopsy-proven Nonalcoholic Fatty Liver Disease

Li¹,

Tang²,

Zhu³

et al. 2021

J Clin Transl Hepatol

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Background and Aims: Intra-abdominal visceral fat accumulation and patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 G/C gene polymorphism confer a greater susceptibility to nonalcoholic fatty liver disease (NAFLD). We examined whether the relationship between visceral fat accumulation and liver disease severity may be influenced by PNPLA3 rs738409 polymorphism. Methods: The variant of PNPLA3 rs738409 was genotyped within 523 Han individuals with biopsy-confirmed NAFLD. Visceral fat area (VFA) was measured by bioelectrical impedance. Significant liver fibrosis (SF), defined as stage F ≥2 on histology, was the outcome measure of interest. Results: The distribution of PNPLA3 genotypes was CC: 27.5%, CG: 48.2%, and GG: 24.3%. Higher VFA was associated with greater risk of having SF (adjusted-odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.02-1.04, p<0.05), independent of potential confounders. Among subjects with the same VFA level, the risk of SF was greater among carriers of the rs738409 G genotype than among those who did not. Stratified analysis showed that PNPLA3 rs738409 significantly influenced the association between VFA and SF.VFA remained significantly associated with SF only among the rs738409 G-allele carriers (adjusted-OR: 1.05; 95% CI: 1.03-1.08 for the GG group; and adjusted-OR:1.03; 95% CI: 1.01-1.04 for the GC group). There was a significant interaction between VFA and PNPLA3 rs738409 genotype (P interaction =0.004). Conclusions: PNPLA3 rs738409 G allele has a moderate effect on the association between VFA and risk of SF in adult individuals with biopsy-proven NAFLD. Existence of the PNPLA3 rs738409 G allele and VFA interact to increase risk of SF.

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Visceral fat area to appendicular muscle mass ratio as a predictor for nonalcoholic fatty liver disease independent of obesity

Cited by 13 publications

References 39 publications

Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China

Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China

Sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio and non-alcoholic steatohepatitis in patients with biopsy-proven non-alcoholic fatty liver disease

PNPLA3 rs738409 C>G Variant Influences the Association Between Visceral Fat and Significant Fibrosis in Biopsy-proven Nonalcoholic Fatty Liver Disease

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