External validation of the fatty liver index and lipid accumulation product indices, using 1H-magnetic resonance spectroscopy, to identify hepatic steatosis in healthy controls and obese, insulin-resistant individuals

Cuthbertson, Daniel J.; Weickert, Martin O.; Lythgoe, Daniel; Sprung, Victoria S.; Dobson, Rebecca; Shoajee-Moradie, Fariba; Umpleby, A. Margot; Pfeiffer, Andreas F. H.; Thomas, E. Louise; Bell, Jimmy D.; Jones, Helen; Kemp, Graham J.

doi:10.1530/eje-14-0112

Cited by 145 publications

(144 citation statements)

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“…Complete objective monitoring of physical activity throughout ensured that the baseline criteria of >10,000 steps/day was met and likewise~1500 steps/day (>80% step reduction) during inactivity; habitual activity was monitored during the final 14 days, with no instruction or guidance; further, we characterised the time participants spent in domains of activity. Moreover, the participants were comprehensively phenotyped, including all measures of the metabolic syndrome, region-specific distribution and quantification of lean muscle and adipose tissue by DXA, and liver fat was quantified by 1 H-MRS, a highly sensitive non-invasive method [35].…”

Section: Discussionmentioning

confidence: 99%

Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes

et al. 2018

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Aims/hypothesis Low physical activity levels and sedentary behaviour are associated with obesity, insulin resistance and type 2 diabetes. We investigated the effects of a short-term reduction in physical activity with increased sedentary behaviour on metabolic profiles and body composition, comparing the effects in individuals with first-degree relatives with type 2 diabetes (FDR+ve) vs those without (FDR−ve). Methods Forty-five habitually active participants (16 FDR+ve [10 female, 6 male] and 29 FDR−ve [18 female, 11 male]; age 36 ± 14 years) were assessed at baseline, after 14 days of step reduction and 14 days after resuming normal activity. We determined physical activity (using a SenseWear armband), cardiorespiratory fitness (V : O 2peak ), body composition (dual-energy x-ray absorptiometry/magnetic resonance spectroscopy) and multi-organ insulin sensitivity (OGTT) at each time point. Statistical analysis was performed using a two-factor between-groups ANCOVA, with data presented as mean ± SD or (95% CI). Results There were no significant between-group differences in physical activity either at baseline or following step reduction. During the step-reduction phase, average daily step count decreased by 10,285 steps (95% CI 9389, 11,182; p < 0.001), a reduction of 81 ± 8%, increasing sedentary time by 223 min/day (151, 295; p < 0.001). Pooling data from both groups, following step reduction there was a significant decrease in whole-body insulin sensitivity (Matsuda index) (p < 0.001), muscle insulin sensitivity index (p < 0.001), cardiorespiratory fitness (p = 0.002) and lower limb lean mass (p = 0.004). Further, there was a significant increase in total body fat (p < 0.001), liver fat (p = 0.001) and LDL-cholesterol (p = 0.013), with a borderline significant increase in NEFA AUC during the OGTT (p = 0.050). Four significant between-group differences were apparent: following step reduction, FDR+ve participants accumulated 1.5% more android fat (0.4, 2.6; p = 0.008) and increased triacylglycerol by 0.3 mmol/l (0.1, 0.6; p = 0.044). After resuming normal activity, FDR+ve participants engaged in lower amounts of vigorous activity (p = 0.006) and had lower muscle insulin sensitivity (p = 0.023). All other changes were reversed with no significant between-group differences. Conclusions/interpretation A short-term reduction in physical activity with increased sedentary behaviour leads to a reversible reduction in multi-organ insulin sensitivity and cardiorespiratory fitness, with concomitant increases in central and liver fat and dyslipidaemia. The effects are broadly similar in FDR+ve and FDR−ve individuals. Public health recommendations promoting physical activity should incorporate advice to avoid periods of sedentary behaviour.

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Section: Discussionmentioning

confidence: 99%

Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes

et al. 2018

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“…The fatty liver index (FLI) [5], the hepatic steatosis index (HSI) [6] and lipid accumulation product (LAP) [7] have been derived and utilized to screen hepatic steatosis in large epidemiologic studies or identify potential patients for further examination in clinical practice. The evaluation of the indexes' diagnostic performance has been reported in Europe [8] and Asia [9,10] over the past decade; however, external validation of them in western China is rare.…”

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confidence: 99%

Validation of simple indexes for nonalcoholic fatty liver disease in western China: a retrospective cross-sectional study

Zhu

Zhang

et al. 2018

Endocr J

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Abstract. Various noninvasive algorithms have been developed for predicting the presence of nonalcoholic fatty liver disease (NAFLD). The evaluation of the indexes' diagnostic performance has been reported in Europe and Asia over the past decade; however, external validation of them in China is rare. This study was aimed to evaluate various indexes for NAFLD in western China. It was a retrospective cross-sectional study, using data from a large-scale health check-up project at Sichuan provincial hospital. Receiver operating characteristic (ROC) curves of eight indexes, including the fatty liver index (FLI), the hepatic steatosis index, lipid accumulation product and etc., were developed to predict ultrasonographic NAFLD. There were 13,122 subjects in this study (2,692 NAFLD patients and 10,430 non-NAFLD participants). The area under ROC curve of FLI for predicting NAFLD was 0.880 (95% confidence interval, 0.874-0.886), which was significantly higher than other seven indexes. Accuracy, sensitivity and specificity of FLI for NAFLD were good (cut-off value = 30, 0.782, 0.832, 0.770 and cut-off value = 60, 0.838, 0.443, 0.940, respectively). Furthermore, FLI also presented advantages in expenditure and accessibility, compared with other indexes. It supports FLI as an easily accessible index for physicians and a reliable predictor for NAFLD screening in western China.

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“…NAFLD was diagnosed using the fatty liver index (FLI) score. FLI requires for calculation BMI, WC, triglycerides, and GGT [13]. A FLI score > 60 is considered to be suggestive for the presence of NAFLD [13].…”

Section: Assay and Indices Assessmentmentioning

confidence: 99%

“…The gold standard for NAFLD diagnosis is the liver biopsy but its invasive nature limits its use. Fatty liver index (FLI) score [12] is a noninvasive method widely used in epidemiological studies for NAFLD screening, showing good sensitivity compared with magnetic resonance spectroscopy for detecting fatty liver [13].…”

Section: Introductionmentioning

confidence: 99%

“…FLI requires for calculation BMI, WC, triglycerides, and GGT [13]. A FLI score > 60 is considered to be suggestive for the presence of NAFLD [13].Carotid Ultrasound Measurements Ultrasound evaluations were performed by a single examiner (with a 15-year expertise, certified for carotid ultrasonography) using a 3-10 MHz VF8-3 linear Transducer (ACUSON X300 Ultrasound System). The examination was performed with the patient lying in supine position, with a lateral probe position using a standardized protocol [25].…”

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confidence: 99%

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Non-alcoholic fatty liver disease, bulb carotid intima-media thickness and obesity phenotypes: results of a prospective observational study

2017

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IntroductionObesity represents a public health problem due to its increasing prevalence despite public awareness programs [1]. Based on cardiovascular (CV) risk factors, clinical studies have identified 2 types of obesity -metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). MHO are characterized by the presence of obesity as defined by a body mass index (BMI) equal or over 30 kg/m 2 without metabolic CV risk factors. MUHO associates obesity with the presence of metabolic CV risk factors and an increased risk of diabetes and CV diseases [2][3][4]. Studies assessing the health risks associated with MHO have shown conflicting results, some showing similar or lower risk of CV disease and diabetes when compared to MUHO. Despite numerous clinical cross-sectional and prospective epidemiological studies evaluating the CV risk associated with this obesity phenotype and its clinical implications, controversies surrounding the health risks associated with MHO remain [5][6][7]. Therefore, it still under debate whether MHO represents a distinct phenotype compared with MUHO (lower health associated risks during lifetime or just a MUHO precursor) [8].In parallel with the increasing prevalence of obesity an increased prevalence of nonalcoholic fatty liver disease (NAFLD) has been reported [9]. Obesity and ab- AbstractAims: The objective of this prospective study was to assess the correlation between carotid intima-media thickness at the common carotid (CIMTc) and carotid bifurcation (CIMTb) level, hepatic fat accumulation, and obesity phenotypes. Material and methods: Two hundred obese adults, in which CIMTc and CIMTb thickness was determined, were included. According to body mass index (BMI) and presence of metabolic syndrome (MetS), patients were classified as metabolically healthy obese (MHO, obesity without MetS) and metabolically unhealthy obese (MUHO, obesity with MetS). MHO patients were further classified as MHO1 (obese with increased waist circumference) and MHO2 (obese with increased waist circumference plus one of the 4 criteria for MetS). Non-alcoholic fatty liver disease (NAFLD) presence was assessed by fatty liver index (FLI). Results: CIMTc and CIMTb increased with obesity phenotypes from 0.74 mm and 1.04 mm in MHO1 to 0.84 mm and 1.23 mm in MHO2 and 0.88 mm and 1.74 mm in MUHO. Obesity phenotypes were significantly correlated with CIMTb. NAFLD frequency increased from 66.0% in the MHO1 to 73.0% in the MHO2 and 84.2% in the MUHO (p<0.05). Independent of age, BMI, total cholesterol, HbA1c, and HOMA-IR, the CIMTc was significantly associated with FLI in all obesity phenotypes and CIMTb only in MHO2 and MUHO. Conclusions: Our results suggest that subclinical atherosclerosis varies according to obesity phenotypes and is correlated with the hepatic fat accumulation.Keywords: carotid intima-media thickness; non-alcoholic fatty liver disease; obesity phenotypes Carotid intima-media thickness (CIMT) is a simple and non-invasive method of the assessment of subclinical atherosclerosis and has be...

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External validation of the fatty liver index and lipid accumulation product indices, using 1H-magnetic resonance spectroscopy, to identify hepatic steatosis in healthy controls and obese, insulin-resistant individuals

Cited by 145 publications

References 30 publications

Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes

Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes

Validation of simple indexes for nonalcoholic fatty liver disease in western China: a retrospective cross-sectional study

Non-alcoholic fatty liver disease, bulb carotid intima-media thickness and obesity phenotypes: results of a prospective observational study

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