title: Body fat distribution and risk factors for fibrosis in patients with alcoholic liver disease.
abstract: BACKGROUND
  Only a small proportion of alcoholic patients develop advanced liver disease, suggesting that factors other than alcohol intake may influence alcoholic liver disease (ALD) progression. We have shown that body mass index (BMI) is an independent risk factor for fibrosis in alcohol-induced liver disease and that adipose tissue inflammation is correlated with liver lesions in alcoholic patients. The aim of this study was to determine whether visceral adipose tissue, as assessed by abdominal height measurement, affected individual susceptibility to fibrosis in alcoholic patients.
  
  
  METHODS
  We included 127 consecutive alcoholic patients with abnormal liver test findings for whom liver histology data were available. Abdominal height was measured with a Holtain-Kahn abdominal caliper. We carried out univariate comparisons followed by multivariate regression analysis, to investigate the relationship between abdominal height and fibrosis score.
  
  
  RESULTS
  Abdominal height (p < 0.005), waist circumference (p < 0.05), fasting blood glucose concentration (p < 0.05), serum triglyceride concentration (p < 0.05), serum bilirubin (p < 0.005), and BMI (p = 0.05) were higher, whereas high-density lipoprotein (HDL) cholesterol level (p < 0.01) was lower in the 72 patients with significant (F2-F4) fibrosis than in the 55 patients with F0-F1 fibrosis. In multivariate regression analysis, only abdominal height (β = 7.2, p < 0.002) was independently and positively correlated with fibrosis score, which was also negatively correlated with HDL cholesterol level (β = -1.04, p < 0.05).
  
  
  CONCLUSIONS
  We provide the first demonstration that abdominal height may be a predictor of significant fibrosis in patients with ALD. Our findings support a role for visceral fat accumulation, independent of BMI and of metabolic syndrome criteria, in the onset of alcoholic liver damage.
authors.affiliation: Service d'Hépato-gastroenterologie, AP-HP, Hôpital Antoine Béclère, Clamart, France. sylvie.naveau@abc.aphp.fr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naveau
authors.forename: Anca-Stela
authors.initials: AS
authors.lastname: Dobrin
authors.forename: Axel
authors.initials: A
authors.lastname: Balian
authors.forename: Micheline
authors.initials: M
authors.lastname: Njiké-Nakseu
authors.forename: Pascal
authors.initials: P
authors.lastname: Nohra
authors.forename: Amani
authors.initials: A
authors.lastname: Asnacios
authors.forename: Sophie
authors.initials: S
authors.lastname: Prévot
authors.forename: Gabriel
authors.initials: G
authors.lastname: Perlemuter
mesh_terms: D001663:Bilirubin / Q000378:metabolism; D001786:Blood Glucose / Q000187:drug effects; D050218:Body Fat Distribution; D015992:Body Mass Index; D002784:Cholesterol / Q000378:metabolism; D004198:Disease Susceptibility; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism; D055105:Waist Circumference / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D001663:Bilirubin