期刊
JOURNAL OF HEPATOLOGY
卷 54, 期 6, 页码 1244-1249出版社
ELSEVIER
DOI: 10.1016/j.jhep.2010.09.037
关键词
NASH; Waist circumference; NAFLD; Abdominal obesity; Glucose metabolism
资金
- FIRST Universita di Milano
- Ricerca Corrente Ospedale Maggiore Policlinico
- Centro Studi Malattie Metaboliche del Fegato
- European Community [HEALTH-F2-2009-241762]
Background & Aims: Increased visceral adiposity is considered the hallmark of the metabolic syndrome, whose hepatic manifestation is nonalcoholic fatty liver disease (NAFLD), although a subset of patients does not have visceral obesity. Our study aimed to compare metabolic alterations and liver damage in patients with NAFLD with and without visceral obesity. Methods: Four hundred and thirty one consecutive patients with liver biopsy-confirmed NAFLD were divided in three groups according to waist circumference, the simplest surrogate marker of visceral obesity. One hundred and thirty three patients (31%) had a waist circumference <= 94 (males) and <= 80 cm (females) (group A), 157 (36%) between 94 and 102, and 80 and 88 (B), and the remaining 141(33%) had values higher than 102 and 88 cm (C). Results: Significant trends for older age, higher prevalence of female gender, lower HDL, higher triglycerides, altered glucose metabolism, hypertension, and metabolic syndrome were observed with increasing visceral adiposity. In contrast, non-alcoholic steato-hepatitis (NASH) detected in 55% and 72% of patients with normal and increased waist circumference, respectively, and the presence of fibrosis >= 2 were not associated with visceral adiposity. Alanine aminotransferase (ALT), ferritin, HOMA-IR >4, and severe steatosis were independently associated with NASH, whereas ferritin and impaired glucose tolerance were associated with fibrosis >= 2. Conclusions: Patients with normal waist circumference, despite milder metabolic alterations, may have NASH and are at risk of developing fibrosis, suggesting that once NAFLD is present, visceral obesity is not a major determinant of liver damage severity. (C) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据