Waist circumference is independently associated with liver steatosis and fibrosis in LMNA-related and unrelated Familial Partial Lipodystrophy women

Abstract

Background Lipodystrophies are a heterogeneous group of diseases characterized by the selective loss of subcutaneous adipose tissue and ectopic fat deposition in different organs, including the liver. This study aimed to determine the frequencies of liver steatosis (LS) and liver fibrosis (LF) in a sample of individuals with LMNA-related and unrelated Familial Partial Lipodystrophy. Methods This cross-sectional study included 17 women with LMNA-related FPLD and 15 women with unrelated FPLD. LS and LF were assessed using transient elastography (TE) with FibroScan®. Anthropometric and biochemical variables were included in a multiple linear regression analysis to identify the variables that were independently related to liver disease. Results Regarding the presence of LF, 22 (68.2%) women were classified as having non-significant fibrosis, and 10 (31.8%) were classified as having significant or severe fibrosis. Regarding LS, only six women (20.7%) were classified as having an absence of steatosis, and 23 (79.3%) had mild to severe steatosis. After multiple linear regression, waist circumference (but not age, body mass index, or waist-to-hip ratio) was found to be independently related to LS and LF. Among the biochemical variables, only triglyceride levels were independently related to LS but not LF. Conclusions In women with FPLD, visceral fat accumulation appears to be the most important determinant of liver disease, including LF, rather than fat scarcity in the lower limbs.

Reply: Concerns regarding the use of Fatty Liver Index in studies of lean NAFLD

“…Building upon existing literature, we explored the role of waist circumference, which is part of the calculation of FLI and a better reflection of visceral adipose tissue than body mass index, as a predictor of liver steatosis and fibrosis, as demonstrated in prior studies. [4] Notably, in our study population, we observed that lean NAFLD with normal GGT exhibited a significantly higher waist circumference (81.1 vs. 76.8, p < 0.00001) compared to those with elevated GGT. Moreover, the severity of fibrosis demonstrated a positive correlation with waist circumference (data not shown).…”