Obesity and liver disease

Scheen, André; Luyckx, Françoise

doi:10.1053/beem.2002.0225

Cited by 119 publications

(93 citation statements)

References 98 publications

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“…It is well documented that fatty liver is associated with obesity, and many studies have shown that increased body mass index, waist circumference and waist-hip ratio [4][5][6]13 were correlated with higher risk of fatty liver. Various types of adipose tissue (subcutaneous versus visceral and portal versus nonportal visceral fat) exhibit different metabolic characteristics.…”

Section: Discussionmentioning

confidence: 99%

Mesenteric fat thickness as an independent determinant of fatty liver

Liu

Chan

et al. 2006

Int J Obes

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Objective: Mesenteric fat is drained by the portal circulation and has been suggested to be a key component in obesity-related health risk, notably the metabolic syndrome. There are increasing epidemiological and experimental data showing that fatty liver is another component of this multifaceted syndrome. Given their intimate anatomical and physiological relationships, we hypothesized that mesenteric fat thickness may be independently associated with the risk of fatty liver. To test this hypothesis, we examined the predictive role of various fat deposits including mesenteric fat thickness, and various metabolic variables on the risk of fatty liver. Subjects and methods: A total of 291 Chinese subjects (134 men and 157 women with a mean BMI of 23.7 kg/m 2 , range: 16.5-33.4 kg/m 2 ) underwent ultrasound examination for measurement of mesenteric, subcutaneous and preperitoneal fat thickness, and for diagnosis of fatty liver. Body mass index, waist circumference, and waist-hip ratio were recorded. Blood pressure was measured. Fasting plasma glucose, insulin resistance, high-density lipoprotein cholesterol (HDL-C), triglycerides, low-density lipoprotein cholesterol (LDL-C), liver enzymes were determined by common methods. Results: The subjects with fatty liver had greater abdominal fat thickness and higher anthropometric indexes than those without fatty liver. The subjects with fatty liver also showed higher blood pressure, worse lipid and glycaemic profile compared with those without fatty liver. Using multiple logistic regression analysis, mesenteric fat thickness was a risk factor of fatty liver, independent of body mass index, age, sex, insulin resistance, fasting plasma glucose, lipid and blood pressure. The odds ratio was 1.5 (95% confidence interval: 1.27-1.77) for every 1 mm increase in the mesenteric fat thickness. Measurement of preperitoneal and subcutaneous fat deposits did not show significant associations with fatty liver. Conclusion: Mesenteric fat thickness measured on ultrasound is an independent determinant of fatty liver.

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Section: Discussionmentioning

confidence: 99%

Mesenteric fat thickness as an independent determinant of fatty liver

Liu

Chan

et al. 2006

Int J Obes

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“…Both the development of NAFLD and its progression to the more severe histology of NASH are associated with obesity and type 2 diabetes (55)(56)(57)(58)(59). NASH is known to progress to cirrhosis in up to 25% of patients (60). Serum transaminase concentrations are unreliable predictors of NAFLD, but an aspartate aminotransferase-to-alanine aminotransferase ratio Ͼ 1 has been associated with more advanced inflammation or fibrosis (61).…”

Section: Liver Diseasementioning

confidence: 99%

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

et al. 2005

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Criteria for patient selection and multidisciplinary evaluation and treatment of the weight loss surgery patient. Obes Res. 2005;13:234 -243. Objective: To provide evidence-based guidelines for patient selection and to recommend the medical and nutritional aspects of multidisciplinary care required to minimize perioperative and postoperative risks in patients with severe obesity who undergo weight loss surgery (WLS). Research Methods and Procedures: Members of the Multidisciplinary Care Task Group conducted searches of MEDLINE and PubMed for articles related to WLS in general and medical and nutritional care in particular. Pertinent abstracts and literature were reviewed for references. Multiple searches were carried out for various aspects of multidisciplinary care published between 1980 and 2004. A total of 3000 abstracts were identified; 242 were reviewed in detail. Results: We recommended multidisciplinary screening of WLS patients to ensure appropriate selection; preoperative assessment for cardiovascular, pulmonary, gastrointestinal, endocrine, and other obesity-related diseases associated with increased risk for complications or mortality; preoperative weight loss and cessation of smoking; perioperative prophylaxis for deep vein thrombosis and pulmonary embolism (PE); preoperative and postoperative education and counseling by a registered dietitian; and a well-defined postsurgical diet progression. Discussion: Obesity-related diseases are often undiagnosed before WLS, putting patients at increased risk for complications and/or early mortality. Multidisciplinary assessment and care to minimize short-and long-term risks include: comprehensive medical screening; appropriate pre-, peri-, and postoperative preparation; collaboration with multiple patient care disciplines (e.g., anesthesiology, pulmonary medicine, cardiology, and psychology); and long-term nutrition education/counseling.

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“…9 In addition to the increased vascular events among subjects with the MS, nonalcoholic fatty liver disease (NAFLD), an additional feature of the MS with specific hepatic insulin resistance, 10 has become the second or third commonest liver disease. 11,12 In a population study, the majority of aminotransferase elevation could not be explained by alcohol, viral hepatitis, or hemochromatosis. Rather, unexplained alanine aminotransferase (ALT) elevation was strongly associated with the adiposity and features of the MS. 13 Usually, NAFLD patients had an elevated ALT enzymatic activity, 14 but a normal ALT did not guarantee freedom from underlying steatohepatitis with advanced fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome and ALT: a community study in adult Koreans

Nam

et al. 2004

Int J Obes

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OBJECTIVE:To investigate an association between the metabolic syndrome (MS) and alanine aminotransferase (ALT) of normal ranges. DESIGN: A population-based cross-sectional survey in three rural communities, South Korea. SUBJECTS: A total of 1248 men and 2157 women aged 30 y and older. MEASUREMENTS: Body mass index (BMI), waist circumference, fasting blood lipid and glucose, resting blood pressure, and ALT. RESULTS: ALT and BMI increased with an addition of the MS components. A consistent association between ALT more than 15 IU/l and the MS was found in both sexes, independently of age, education, BMI, smoking, alcohol drinking, and sedentary life style. The odds ratios for the MS in the highest quintiles of ALT were 7.1-fold higher than the reference quintile in men and 2.1-fold higher in women. The likelihood ratio tests for trend were also significant with ALT increments (Po0.001 for trend). CONCLUSION: The MS is significantly associated with the higher quintiles of normal ALT in both genders. ALT could be a sensitive marker of hepatic dysfunction associated with the MS, even in the range below the current limit.

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Obesity and liver disease

Cited by 119 publications

References 98 publications

Mesenteric fat thickness as an independent determinant of fatty liver

Mesenteric fat thickness as an independent determinant of fatty liver

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

Metabolic syndrome and ALT: a community study in adult Koreans

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