Relative fat mass at baseline and its early change may be a predictor of incident nonalcoholic fatty liver disease

Kim, Hwi Young; Baik, Su Jung; Lee, Hye Ah; Lee, Byoung Kwon; Lee, Hye Sun; Kim, Tae Hun; Yoo, Kwon

doi:10.1038/s41598-020-74659-9

Cited by 13 publications

(16 citation statements)

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“…Neither weight- nor height-adjusted SMI did however show the anticipated inverse association with NASH in this study, suggesting that sarcopenia in patients with obesity might not be the decisive factor for developing NASH. Confirming this, a large prospective cohort study found an increased risk for incident NAFLD in patients with overweight and obesity with higher FM at baseline, while lower SMI did not show a significant association with incident NAFLD during a mean follow-up of 48.5 months [ 15 ].…”

Section: Discussionmentioning

confidence: 70%

“…The relation of sarcopenia with NAFLD and NASH has been subject of recent discussions [ 1 , 5 , 7 , 9 , 16 , 17 , 34 , 35 , 36 ]. This connection is especially interesting in patients with obesity and sarcopenic obesity (SO), as high amounts of visceral fat have been described to be predisposing for NAFLD and NASH [ 13 , 15 ]. The aim of this study was to assess the association of body composition and NASH in patients with obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Higher amounts of body fat can be seen as predisposing factors for the development of NAFLD and NASH [ 12 , 13 , 14 ]. Therefore, a population especially vulnerable for NAFLD and NASH are patients with obesity, who naturally suffer from excess fat masses (FM) [ 15 ]. Contrary, the role of decreased skeletal muscle mass (SMM), (sarcopenia) for development of NASH is the subject of discussions.…”

Section: Introductionmentioning

confidence: 99%

“…Contrary, the role of decreased skeletal muscle mass (SMM), (sarcopenia) for development of NASH is the subject of discussions. For diagnosis of sarcopenia, the relative SMM, as indicated by skeletal muscle index (SMI), is used most widely [ 4 , 8 , 15 ]. In lean patients, the SMI has been described to be inversely associated with NAFLD [ 6 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of Body Composition and Sarcopenia with NASH in Obese Patients

Schmitz

Schooren

Kroh

et al. 2021

JCM

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Obese patients often suffer from sarcopenia or sarcopenic obesity (SO) that can trigger inflammatory diseases including non-alcoholic steatohepatitis (NASH). Sarcopenia and SO can be diagnosed through measuring parameters of body composition such as skeletal muscle mass (SMM), skeletal muscle index (SMI) and fat mass (FM) obtained by bioelectrical impedance analysis (BIA). The aim of this study was to assess the relationship of body composition and NASH in patients with obesity. A total of 138 patients with obesity that underwent bariatric surgery were included in this study. BIA was used to estimate body composition. A liver biopsy was taken intraoperatively and histological assessment of NASH was performed. A total of 23 patients (17%) were classified as NASH and 65 patients (47%) met the criteria for borderline NASH. Body mass index (BMI) was significantly higher in patients with NASH compared to borderline NASH and no NASH (56.3 kg/m2 vs. 51.6 kg/m2 vs. 48.6 kg/m2, p = 0.004). Concerning body composition, FM, but also SMM and SMI were significantly higher in patients with NASH (p-values 0.011, 0.005 and 0.006, resp.). Fat mass index (FMI) and weight-adjusted skeletal muscle index (SMI_weight) failed to reach statistical significance (p-values 0.067 and 0.661). In patients with obesity, higher FM were associated with NASH. Contrary to expectations, SMM and SMI were also higher in patients with NASH. Therefore, higher body fat, rather than sarcopenia and SO, might be decisive for development of NASH in patients with obesity.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Body Composition and Sarcopenia with NASH in Obese Patients

Schmitz

Schooren

Kroh

et al. 2021

JCM

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“…A cross-sectional study in the Netherlands population reported that an increase of total fat mass was significantly associated with a higher risk of NAFLD both in participants with normal weight and in overweight [ 27 ]. A longitudinal study found that higher fat percentage at baseline may be a predictor of incident NAFLD across all obesity spectrum [ 28 ]. At the same time, emerging evidence suggested that the substantial loss of muscle mass, the main component of fat-free mass, termed as ‘sarcopenia’, had a negative effect on the risk of NAFLD and fibrosis independent of obesity.…”

Section: Discussionmentioning

confidence: 99%

Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

Dai¹,

Xiang²,

Hou³

et al. 2021

Nutr Metab (Lond)

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Context Body composition may explain partially why non-obese individuals still at the risk of developing non-alcoholic fatty liver disease (NAFLD). The ratio of fat mass to fat-free mass (FM/FFM) has been proposed to assess the combined effect of different body compositions. Objective We aimed to investigate the associations of FM/FFM ratio with the risk of developing NAFLD and fibrosis and to identify the potential mediators according to obesity status. Methods This cohort study comprised 3419 adults age ≥ 40 years and free of NAFLD at baseline. Body composition was measured by bioelectrical impedance analysis. NAFLD was ascertained by ultrasonography and fibrosis was assessed by non-invasive score systems. Results For each 1 standard deviation increment in FM/FFM ratio, the odds ratio for the risk of NAFLD was 1.55 (95% confidence interval [CI] 1.23–1.95) in non-obese men, 1.33 (95% CI 1.08–1.65) in obese men, 1.42 (95% CI 1.44–1.67) in non-obese women, and 1.29 (95% CI 1.12–1.50) in obese women. Similar associations were also found between FM/FFM ratio and NAFLD with fibrosis. Mediation analysis showed that insulin resistance, triglycerides, high-density lipoprotein cholesterol, white blood cells, and total cholesterol mediated the association of FM/FFM ratio with NAFLD risk in specific sex and obesity subgroups. Conclusions The FM/FFM ratio significantly associated with the NAFLD and fibrosis risk in both non-obese and obese individuals. Different factors may mediate the association between body composition and NAFLD risk according to different obesity status.

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Regional fat distribution and hepatic fibrosis and steatosis severity in patients with nonalcoholic fatty liver disease and type 2 diabetes

Mansour,

Pourhassan,

Gerami

et al. 2024

Obesity Science & Practice

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BackgroundEpidemiologic findings suggest that measures of body fat distribution predict health outcomes independent of the overall body fat assessed by body mass index (BMI). This study aimed to evaluate the associations of overall and regional body fat with the severity of hepatic steatosis and fibrosis in type 2 diabetic patients with non‐alcoholic fatty liver disease.MethodsBioelectric impedance analysis and two newly developed anthropometric indices, namely, A Body Shape Index (ABSI) and Body Roundness Index (BRI), were used to estimate the body fat. Based on fibroscan parameters, significant hepatic fibrosis and severe steatosis were defined as ≥F2 and >66%, respectively.ResultsHigher total body fat (odds ratio [OR] 1.107, 95% confidence intervals (CI) 1.038–1.182, p = 0.002), trunk fat (OR 1.136, 95% CI 1.034–1.248, p = 0.008) and leg fat (OR 1.381, 95% CI 1.139–1.674, p = 0.001) were associated with liver fibrosis. However, in contrast to the total body fat (OR 1.088, 95% CI 1.017–1.164, p = 0.014) and leg fat (OR 1.317, 95% CI 1.066–1.628, p = 0.011), the trunk fat was not associated with severe hepatic steatosis. BRI performed better than trunk, leg and total body fat in predicting hepatic steatosis (OR 2.186, 95% CI 1.370–3.487, p = 0.001) and fibrosis (OR 2.132, 95% CI 1.419–3.204, p < 0.001). Moreover, the trunk to leg fat ratio and ABSI were not independent predictors of either steatosis or fibrosis (p > 0.05).ConclusionBRI revealed a superior predictive ability for identifying the degree of hepatic steatosis and stiffness than other obesity indices. Additionally, higher levels of adiposity in the trunk, legs, and overall body were linked to an increased risk of developing liver fibrosis. Although trunk fat did not show an association with severe hepatic steatosis, an increase in leg and total fat was related to liver steatosis.

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Relative fat mass at baseline and its early change may be a predictor of incident nonalcoholic fatty liver disease

Cited by 13 publications

References 50 publications

Association of Body Composition and Sarcopenia with NASH in Obese Patients

Association of Body Composition and Sarcopenia with NASH in Obese Patients

Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

Regional fat distribution and hepatic fibrosis and steatosis severity in patients with nonalcoholic fatty liver disease and type 2 diabetes

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