title: Regional anthropometric measures associated with the severity of liver injury in patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Not all NAFLD patients are obese and many obese patients do not have NAFLD. Impaired peripheral fat storage may increase the delivery of lipids to the liver and facilitate NAFLD progression.
  
  
  OBJECTIVE
  To assess the association of anthropometric measures of regional adiposity including arm fat index (AFI) (upper body fat), waist circumference (visceral fat) and body mass index (total body fat) on liver injury and fibrosis in NAFLD.
  
  
  METHODS
  One hundred and forty-one patients with histological evidence of NAFLD were included in this study. Multivariate logistic regression models examined the contribution of age, sex, body mass index, AFI, triceps fold thickness (TST), waist and hip circumference to the odds of liver injury (NAS scores ≥3) and fibrosis (fibrosis scores ≥2) by liver biopsy.
  
  
  RESULTS
  Arm fat index (OR: 0.82, 95% CI: 0.59-0.91) and TST (OR: 0.13, 95% CI: 0.04-0.42) were negatively correlated with NAFLD histological severity. In women, waist circumference was positively correlated with NAFLD severity (OR: 1.21(1.02-1.44). Age (OR: 1.05, 95% CI: 1.01-1.0) and waist circumference (OR: 1.07, 95% CI: 1.00-1.15) were significantly associated with fibrosis risk. In women, AFI (OR: 0.87, 95% CI: 0.76-0.99) and TST (OR: 0.22, 95% CI: 0.05-0.95) were negatively associated with fibrosis risk.
  
  
  CONCLUSIONS
  Regional anthropometric measures are associated with severity of NAFLD in a sex-specific manner. Men and women with lower arm fat depots and women with bigger waist circumference have a greater likelihood of liver injury. Age and waist circumference seem to be associated with liver fibrosis. Simple anthropometric measurements of peripheral fat deposits may help stratify significant liver injury risk.
authors.affiliation: National Institute for Health Research Biomedical Research Unit in Gastrointestinal and Liver Disease, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.
authors.forename: V
authors.initials: V
authors.lastname: Subramanian
authors.forename: R D
authors.initials: RD
authors.lastname: Johnston
authors.forename: P
authors.initials: P
authors.lastname: Kaye
authors.forename: G P
authors.initials: GP
authors.lastname: Aithal
mesh_terms: D000328:Adult; D000886:Anthropometry; D001837:Body Weights and Measures; D005234:Fatty Liver / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D050151:Subcutaneous Fat