Waist circumference is associated with liver fat in black and white adolescents

Abstract

Abstract:We examined whether waist circumference (WC) is associated with liver fat in black and white adolescents. Liver fat was measured using a 3T proton magnetic resonance spectroscopy ( 1 H-MRS) in 152 overweight/obese adolescents (94 black and 58 white, body mass index (BMI) ≥85th percentile, aged 12-18 years) without liver diseases or diabetes. WC was measured at the last rib. Total and visceral adipose tissue (VAT) were measured by dual-energy X-ray absorptiometry and magnetic resonance imaging, respectively. The proportion of fatty liver (defined as liver fat ≥5.0% by 1 H-MRS) was lower (P < 0.01) in black adolescents (5.3%) compared with their white peers (24.1%). Despite similar age, BMI, WC, and total adiposity (%), black adolescents had lower (P < 0.01) VAT (59.0% vs. 81.3 cm 2 ), liver fat (1.6% vs. 3.5%), and alanine aminotransferase (17.2 vs. 22.0 IU/L) compared with their white peers. Independent of race, WC was associated with liver fat (black, r = 0.43; white, r = 0.64) in a similar magnitude to the association between VAT and liver fat (black, r = 0.44; white, r = 0.51) and these findings remained significant after controlling for age, sex, Tanner stage, and total adiposity. In blacks, WC and sex (male) were independent (P < 0.01) predictors of liver fat, explaining 17.1% and 5.6% of the variance, respectively, while in whites WC was the single best predictor, explaining 40.8% of the variance in liver fat. These findings suggest that enlarged WC is a marker of increased liver fat in overweight/obese white and black adolescents.Key words: childhood obesity, race, waist circumference, visceral fat, non-alcoholic fatty liver disease, proton magnetic resonance spectroscopy. Mots-clés : obésité infantile, race, tour de taille, gras viscéral, stéatose hépatique non alcoolique, spectroscopie par résonance magnétique du proton.

Predictors of liver fat among children and adolescents from five different ethnic groups

“…An interesting report from Mexico found that maternal weight status might be related to fatty liver content in their children as young adults after controlling for their own BMI 40 . Our findings do not agree with a report showing that waist circumference, a measure of abdominal adiposity, was a stronger predictor of liver fat than BMI among a study of adolescents 41 …”

“…The current investigation has several strengths, foremost the MRI‐based measurement of liver fat in a substantial sample size of generally healthy children and adolescents. Previous population surveys classified children and adolescents according to ALT concentrations, 2,6 whereas MRI‐based investigations focused on children with overweight/obesity 15,39,41,42 . The wide age range, the ethnic diversity, and the substantial proportion of participants with overweight and obesity included by design make these findings applicable to a more general population.…”

Anthropometric indicators of visceral adiposity as predictors of non-alcoholic fatty liver disease: A review

“…In the studies selected here it is observed that different methods were used to identify hepatic steatosis: liver biopsy[ 9 ], computed tomography[ 14 ], proton magnetic resonance spectroscopy[ 8 , 15 ] being that the great majority realized abdominal ultrasonography[ 10 , 11 , 16 - 20 ].…”

“…In children, the WC AUC was 0.94, with the cutoff point at the 80th percentile for age, in the study by Zhang et al[ 17 ], a cross sectional study with 7229 students in China. Lee et al[ 15 ] evaluated white and black obese adolescents in the United States and found an optimal WC cutoff point for predicting NAFLD of 101.5 cm, AUC: 0.847, 93% sensitivity and 80% specificity in white obese women, and with no statistical difference between the values found between the blacks. The cross-sectional study by Monteiro et al[ 16 ], which evaluated 145 obese children and adolescents in Brazil, found higher WC (AUC: 0.720) when compared to trunk fat mass (AUC: 0.661), estimated by Dual-energy X-ray absorptiometry, however lower than the intra-abdominal adipose tissue (AUC: 0.741), measured by ultrasound examination.…”

INVESTIGATION OF 2548G>A LEPTINE GENE POLYMORPHIC VARIANT IMPACT ON RISK OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

“…The unequal prevalence of the disease in representatives of different ethnic groups and the different rates of its progression in individuals with the same or similar risk factors and environmental conditions indicate the pathogenetic role of hereditary factors [12,13].…”