title: Liver fat percent is associated with metabolic risk factors and the metabolic syndrome in a high-risk vascular cohort.
abstract: OBJECTIVE
  To determine whether liver fat percent (LFP) is associated with the metabolic syndrome independently of visceral fat area (VFA).
  
  
  METHODS
  43 High-risk vascular patients not on lipid-lowering therapy were evaluated for the Adult Treatment Panel III (ATPIII) metabolic syndrome criteria and underwent magnetic resonance imaging (MRI) to quantify VFA and subcutaneous fat area (SFA) at the L4-L5 disc and liver magnetic resonance spectroscopy (MRS) to quantify LFP. Comparisons: 1. Baseline differences in patients with and without the metabolic syndrome 2. Forward binary logistic regression analysis of predictors of the metabolic syndrome with VFA, SFA and LFP as independents 3. Correlates of LFP.
  
  
  RESULTS
  43 patients were included in analysis. Patients with metabolic syndrome had greater VFA, SFA and LFP than patients without the metabolic syndrome (all p < 0.01). Of VFA, SFA and LFP, only LFP was associated with the diagnosis of the metabolic syndrome on forward binary logistic regression with an OR of 1.17 per 1% increase in LFP (p = 0.015). A 4% LFP threshold identified the metabolic syndrome with 84% sensitivity and 82% specificity. LFP correlated with waist circumference (r = 0.768), HDL-cholesterol (r = -0.342), triglyceride (r = 0.369), fasting glucose (r = 0.584) and the QUICK Index of insulin sensitivity (r = -0.679) (all p < 0.05)
  
  
  CONCLUSIONS
  LFP is associated with the metabolic syndrome and renders the current gold standard of VFA redundant in this analysis. This measure of obesity-related cardiovascular risk requires further validation and evaluation in a prospective cohort.
authors.affiliation: Royal Brisbane and Women's Hospital, University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia. drmhoenig@yahoo.com.au.
authors.forename: Michel R
authors.initials: MR
authors.lastname: Hoenig
authors.forename: Gary
authors.initials: G
authors.lastname: Cowin
authors.forename: Raymond
authors.initials: R
authors.lastname: Buckley
authors.forename: Christine
authors.initials: C
authors.lastname: McHenery
authors.forename: Alan
authors.initials: A
authors.lastname: Coulthard