Visceral adiposity as a risk factor for lean non‐alcoholic fatty liver disease in potential living liver donors

Abstract

Background and Aim This study aimed to investigate the relationship between hepatic steatosis (HS) evaluated by biopsy and visceral adiposity assessed by computed tomography in lean living liver donor candidates and to determine the risk factors for lean non‐alcoholic fatty liver disease (NAFLD). Methods This retrospective study included 250 lean (body mass index, < 23 kg/m2) potential living liver donors (mean age, 31.1 ± 8.6 years; 141 men) who had undergone liver biopsy and abdominal computed tomography between 2017 and 2018. Anthropometry, laboratory parameters, body composition, and the degree of HS were evaluated. Logistic regression was used to identify independent predictors of lean NAFLD. Results The visceral fat area (VFA) was significantly correlated with the degree of HS in men (r = 0.408; P < 0.001) and women (r = 0.360; P < 0.001). The subcutaneous fat area was significantly correlated with the degree of HS in men (r = 0.398; P < 0.001), but not in women. The skeletal muscle area did not correlate with the degree of HS in either men or women. In the multivariable logistic regression analysis, the VFA (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.013–1.044; P < 0.001) and subcutaneous fat area (OR, 1.016; 95% CI, 1.004–1.028; P = 0.009) were independent risk factors for lean NAFLD in men, and the VFA (OR, 1.036; 95% CI, 1.013–1.059; P = 0.002) was an independent risk factor for lean NAFLD in women. Conclusions The severity of non‐alcoholic fatty liver was positively correlated with visceral fat accumulation in a lean Asian population. Visceral adiposity may be a risk factor for lean NAFLD in potential living liver donors.

Genetically Predicted Visceral Adipose Tissue and Risk of Nine Non-tumor Gastrointestinal Diseases: Evidence from A Mendelian Randomization Study

“…Previous research found that NAFLD patients have more VAT than healthy controls 42 . Similarly, we observed a positive causal relationship between genetically predicted VAT and NAFLD risk.…”

Non-Alcoholic Fatty Liver Disease in Lean and Non-Obese Individuals: Current and Future Challenges

“…Regarding hard outcomes, an analysis of the NHANES III survey showed that, compared to healthy lean subjects, lean patients with NAFLD had a 50% increase in all-cause mortality and over a 2-fold increase in cardiovascular mortality [95]. In this line, individuals with lean NAFLD had a significantly higher atherosclerotic cardiovascular disease (ASCVD) score (defined as an ASCVD risk of >10%), 51.6% vs. 39.8% in obese NAFLD and 25.5% in subjects without NAFLD [30]. Additionally, in a recent meta-analysis from the US, non-obese NAFLD individuals had higher 15-year cumulative all-cause mortality (51.7%) than obese NAFLD (27.2%) and non-NAFLD (20.7%) [8].…”

“…Importantly, in people with expanded visceral adiposity, the contribution of VAT to portal vein FFAs' levels can go up to 50% [29]. Recently, a biopsy-based study including 250 lean, potential living liver donors, the severity of NAFLD was positively correlated with visceral fat accumulation [30].…”

Sarcopenia in the setting of nonalcoholic fatty liver

“…A study with 352 participants found a correlation between NAFLD onset and thickness of visceral fats [115] . Francque et al [116] reported a considerable association of visceral obesity with the degree of steatosis.…”