title: Independent and opposite associations of trunk fat and leg fat with liver enzyme levels.
abstract: BACKGROUND
  In contrast to trunk fat mass (TFM), which is associated with cardiovascular risk markers, leg fat mass (LFM) displays independent protective effects against atherosclerosis. Little is known about the respective influence of central and peripheral adiposity on liver enzyme levels.
  
  
  OBJECTIVE
  To assess the respective influence of TFM and LFM on alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) levels, and to test whether LFM might protect against an increase of liver enzyme levels.
  
  
  METHODS
  Cross-sectional study on 1442 patients (women: 1155; men: 287) referred for overweight/obesity over 3 years. Body composition was analysed by dual-energy X-ray absorptiometry. The relationships among liver enzymes, age, weight, height, body mass index (BMI), biological indices and body composition were studied.
  
  
  RESULTS
  The mean BMI was 39.7 +/- 7.9 kg/m(2) in women and 38.2 +/- 6.6 kg/m(2) in men. In women, after adjustement for confounding factors, ALT, AST and GGT were negatively and independently correlated with LFM and positively with TFM. Similar independent associations were observed for ALT and AST in men. The strongest associations were found for ALT in both women and men.
  
  
  CONCLUSIONS
  As observed for cardiovascular risk factors, LFM and TFM are inversely and independently correlated with liver enzyme levels in obese patients. LFM may confer independent protective effects against obesity-associated liver damage.
authors.affiliation: AP-HP, Hôpital Antoine Béclère, Service d'hépato-gastroentérologie, Clamart, France. gabriel.perlemuter@abc.aphp.fr
authors.forename: Gabriel
authors.initials: G
authors.lastname: Perlemuter
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naveau
authors.forename: Frédéric
authors.initials: F
authors.lastname: Belle-Croix
authors.forename: Catherine
authors.initials: C
authors.lastname: Buffet
authors.forename: Hélène
authors.initials: H
authors.lastname: Agostini
authors.forename: Muriel
authors.initials: M
authors.lastname: Laromiguière
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Cassard-Doulcier
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
mesh_terms: D000005:Abdomen / Q000502:physiology*; D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D000886:Anthropometry; D001219:Aspartate Aminotransferases / Q000097:blood; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D007866:Leg / Q000502:physiology*; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000201:enzymology* / Q000503:physiopathology; D012044:Regression Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase