Waist circumference correlates with hepatic fat accumulation in male Japanese patients with non-alcoholic fatty liver disease, but not in females.
OBJECTIVE
Abdominal obesity, a component of metabolic syndrome, is a major risk factor for non-alcoholic fatty liver disease (NAFLD). In recent worldwide definitions of metabolic syndrome, waist measurement has been proposed as a simple and useful estimate of abdominal obesity, taking into account gender differences in waist circumference. The present cross-sectional study investigated the correlation of hepatic fat accumulation and waist circumference in Japanese NAFLD patients to determine if there are gender differences in this relationship.


METHODS
Consecutive patients (n = 2111) who had at least one of two criteria for liver disease (alanine aminotransferase [ALT] level >30 IU/mL and aspartate aminotransferase [AST]/ALT ratio <1) underwent abdominal ultrasonography. Patients positive for hepatitis B virus, hepatitis C virus or autoimmune antibodies and whose alcohol intake was >20 g/day were excluded. Patients with NAFLD underwent abdominal computed tomography. Hepatic fat accumulation was estimated by liver/spleen attenuation ratio (L/S ratio) and visceral adipose accumulation was measured as visceral fat area (VFA) at the umbilical level.


RESULTS
Of the 221 NAFLD patients, 103 were females. In males, the relationship between L/S ratio and waist circumference was negative (r =-0.356, P < 0.01), and there was no correlation in the female group. The relationship between L/S ratio and VFA was negative in both groups (males: r = -0.269, P < 0.01; females: r = -0.319, P < 0.01). Subcutaneous fat area/total fat area ratio at the umbilical level was larger in females than in males (P < 0.01).


CONCLUSIONS
In NAFLD patients, waist measurement is more susceptible to gender differences than VFA.
Ishibashi
Eriko
E
Department of Internal Medicine, Saga Medical School, Saga, Japan.
Eguchi
Yuichiro
Y
Eguchi
Takahisa
T
Matsunobu
Aki
A
Oza
Noriko
N
Nakashita
Shunya
S
Kitajima
Yoichiro
Y
Kuroki
Shigetaka
S
Ozaki
Iwata
I
Kawaguchi
Yasunori
Y
Ide
Yasushi
Y
Yasutake
Tsutomu
T
Iwakiri
Ryuichi
R
Mizuta
Toshihiko
T
Ono
Naofumi
N
Fujimoto
Kazuma
K
D000328:Adult; D000368:Aged; D050218:Body Fat Distribution; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D007564:Japan; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D011859:Radiography; D012307:Risk Factors; D012727:Sex Characteristics; D014463:Ultrasonography; D049629:Waist-Hip Ratio