title: Relation of Anthropometric Obesity and Computed Tomography Measured Nonalcoholic Fatty Liver Disease (from the Multiethnic Study of Atherosclerosis).
abstract: We hypothesized that anthropometric measures of abdominal obesity would have a stronger positive association with nonalcoholic fatty liver disease (NAFLD) measured by noncontrast computed tomography versus general measures of obesity. The Multiethnic Study of Atherosclerosis comprised participants aged 45 to 84 years free of known cardiovascular disease. We studied 4,088 participants with adequate liver and spleen computed tomography imaging and no previous use of oral steroids, class 3 antiarrhythmics, moderately heavy alcohol use, or cirrhosis. Prevalent NAFLD was defined as a liver:spleen Hounsfield attenuation ratio of <1. Multivariable log-linear regression modeled the association of 4 obesity measures-weight, body mass index (BMI), waist circumference, and waist-to-hip ratio-with prevalent NAFLD. Receiver-operator curve analysis compared NAFLD discrimination. Median age was 63 years, and 55% were women. For each obesity measure, adjusted prevalence ratios for NAFLD were fourfold to fivefold greater in the highest versus the lowest quartile (p <0.001). Waist circumference and BMI had the highest prevalence ratios, and waist circumference had the best discrimination, for NAFLD in the total population, although an abnormal BMI categorized subjects with NAFLD as well if not better than waist circumference. In ethnic-specific analysis, whites and Chinese had the strongest association of obesity and NAFLD compared with other ethnicities. In conclusion, although waist circumference provided the best discrimination for NAFLD, BMI may perform similarly well in clinical settings to screen for NAFLD.
authors.affiliation: Division of Cardiology, University of California, San Francisco, California; Division of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, Baltimore, Maryland. Electronic address: geoff.tison@ucsf.edu.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Tison
authors.affiliation: Division of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: Division of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, Baltimore, Maryland; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach, Florida.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Division of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Sticht Center on Aging, Wake Forest School of Medicine, Winston Salem, North Carolina.
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.affiliation: Los Angeles BioMed Research Institute, Harbor-UCLA Medical Center, Torrance, Carolina.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology*; D015992:Body Mass Index; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000208:ethnology*; D056128:Obesity, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D015995:Prevalence; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D044465:White People / Q000706:statistics & numerical data*