title: Association between low thigh fat and non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  Some people have a fatty liver despite having low visceral fat and a low body mass index (BMI). We investigated whether fat distribution, especially thigh subcutaneous fat and thigh intramuscular fat, is associated with non-alcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  The patients consisted of 408 men and women. NAFLD was defined by an ultrasound scan and excluded other liver diseases. Visceral, subcutaneous abdominal, intramuscular, and subcutaneous thigh adipose tissue was measured by computed tomography.
  
  
  RESULTS
  The frequency of NAFLD decreased over a quartile of thigh fat independently of BMI in the female patients. Additional adjustments for age and visceral fat area did not change the results. This finding was not observed in the male patients. To investigate the relationship between each fat distribution and NAFLD, we performed a logistic regression analysis. Fat distribution was divided into four groups: visceral fat, abdominal subcutaneous fat, thigh subcutaneous fat, and thigh intramuscular fat. All four fat components were chosen as variables for the regression model. Age, BMI, and the homeostasis model assessment (HOMA) index were then adjusted successively. A larger subcutaneous fat area was negatively associated with NAFLD after adjustment for visceral fat and abdominal subcutaneous fat areas in women, but not in men. It did not change even after age adjustment, BMI, and the HOMA index.
  
  
  CONCLUSIONS
  Low femoral subcutaneous fat amounts were shown to be independently associated with fatty liver disease in women. These results show the importance of accurate measurements of other regional body compositions as well as visceral fat amounts when investigating NAFLD.
authors.affiliation: Departments of Internal Medicine, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Jun
authors.forename: Jee Hye
authors.initials: JH
authors.lastname: Han
authors.forename: Sang Heum
authors.initials: SH
authors.lastname: Kim
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Jang
authors.forename: Nam In
authors.initials: NI
authors.lastname: Kim
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Song
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Yoon Ju
authors.initials: YJ
authors.lastname: Jo
authors.forename: Young Sook
authors.initials: YS
authors.lastname: Park
mesh_terms: D050153:Abdominal Fat; D000328:Adult; D050218:Body Fat Distribution; D015992:Body Mass Index; D005234:Fatty Liver / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D012044:Regression Analysis; D012307:Risk Factors; D050151:Subcutaneous Fat; D013848:Thigh; D014463:Ultrasonography