title: Increased abdominal fat levels measured by bioelectrical impedance are associated with histological lesions of nonalcoholic steatohepatitis.
abstract: OBJECTIVE
  Abdominal fat is considered to play an important role in nonalcoholic fatty liver disease (NAFLD), although it is not adequately studied because abdominal fat levels cannot be estimated easily. In this study, associations between abdominal obesity, as assessed by abdominal bioelectrical impedance analysis (BIA), and the characteristics of patients with NAFLD were explored.
  
  
  METHODS
  Seventy-four consecutive NAFLD patients who underwent measurement of abdominal fat levels by BIA were included. Levels of abdominal fat 12.5 or less and more than 12.5 were considered to be average and increased, respectively.
  
  
  RESULTS
  The mean±SD BMI was 30±4 kg/m and the mean abdominal fat levels were 16±5, whereas 26% of patients had average abdominal fat levels. Patients with average compared with those with increased abdominal fat levels were more frequently women (50 vs. 12%, P=0.001), had lower BMI (27±3 vs. 31±4 kg/m, P<0.001), lower Homeostasis Model Assessment index (2.6±1.4 vs. 3.9±2.7, P=0.045), and lower median liver stiffness on transient elastography (5.3 vs. 6.8 kPa, P=0.025). In patients with available liver biopsy, steatohepatitis was present more frequently in patients with increased compared with average abdominal fat levels (78 vs. 38%, P=0.030) and in patients with BMI 30 or more compared with less than 30 kg/m (87 vs. 48%, P=0.033), but similar in patients with increased or normal waist circumference (67 vs. 56%, P=0.693).
  
  
  CONCLUSIONS
  Average levels of abdominal fat, as assessed by abdominal BIA, are mainly present in female patients with NAFLD and are associated with a lower degree of insulin resistance. Increased abdominal fat as assessed by BIA and obesity seem to represent strong risk factors for histological steatohepatitis.
authors.affiliation: a2nd Department of Internal Medicine, Hippokration Hospital of Athens bAcademic Department of Gastroenterology, Laiko Hospital of Athens, Athens University Medical School cDepartment of Nutrition and Dietetics, Harokopio University dLaboratory of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Margariti
authors.forename: Meropi D
authors.initials: MD
authors.lastname: Kontogianni
authors.forename: Nafsika
authors.initials: N
authors.lastname: Tileli
authors.forename: Michael
authors.initials: M
authors.lastname: Georgoulis
authors.forename: Melanie
authors.initials: M
authors.lastname: Deutsch
authors.forename: Rodessa
authors.initials: R
authors.lastname: Zafeiropoulou
authors.forename: Dina
authors.initials: D
authors.lastname: Tiniakos
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Pectasides
authors.forename: George V
authors.initials: GV
authors.lastname: Papatheodoridis
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology*; D050154:Adiposity; D000328:Adult; D001706:Biopsy; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology* / Q000473:pathology; D056128:Obesity, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors