title: Phenotype, Body Composition, and Prediction Equations (Indian Fatty Liver Index) for Non-Alcoholic Fatty Liver Disease in Non-Diabetic Asian Indians: A Case-Control Study.
abstract: OBJECTIVE
  In this study, we have attempted comparison of detailed body composition phenotype of Asian Indians with non-alcoholic fatty liver disease (NAFLD) vs. those without, in a case controlled manner. We also aim to analyse prediction equations for NAFLD for non-diabetic Asian Indians, and compare performance of these with published prediction equations researched from other populations.
  
  
  METHODS
  In this case-control study, 162 cases and 173 age-and sex-matched controls were recruited. Clinical, anthropometric, metabolic, and body composition profiles, and liver ultrasound were done. Fasting insulin levels, value of homeostasis model assessment of insulin resistance (HOMA-IR), and serum high sensitive C-reactive protein (hs-CRP) levels were evaluated. Multivariate logistic and linear regression analyses were used to arrive at prediction equations for fatty liver [Indian fatty liver index (IFLI)].
  
  
  RESULTS
  As compared to those without fatty liver, those with fatty liver exhibited the following; Excess dorsocervical fat ('Buffalo hump'), skin tags, xanthelasma, 'double chin', arcus; excess total, abdominal and subcutaneous adiposity, and high blood pressure, blood glucose, measures of insulin resistance (fasting insulin and HOMA-IR values), lipids and hs-CRP levels. Two prediction equations were developed; Clinical [Indian Fatty Liver Index-Clinical; IFLI-C]: 1(double chin) +15.5 (systolic blood pressure) +13.8 (buffalo hump); and IFLI-Clinical and Biochemical (CB): serum triglycerides+12 (insulin)+1(systolic blood pressure) +18 (buffalo hump). On ROC Curve analysis, IFLI performed better than all published prediction equations, except one.
  
  
  CONCLUSIONS
  Non-diabetic Asian Indians with NAFLD researched by us were overweight/obese, had excess abdominal and subcutaneous fat, multiple other phenotypic markers, had higher insulin resistance, glycemia, dyslipidemia and subclinical inflammation than those without. Prediction score developed by us for NAFLD; IFLI-C and IFLI-CB, should be useful for clinicians and researchers.
authors.affiliation: Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India.|Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.|Council of Scientific & Industrial Research-Institute of Genomics and Integrative Biology, Delhi, India.
authors.forename: Surya Prakash
authors.initials: SP
authors.lastname: Bhatt
authors.affiliation: Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India.|Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, B 16, Chirag Enclave, New Delhi, India.
authors.forename: Anoop
authors.initials: A
authors.lastname: Misra
authors.affiliation: Diabetic Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC), New Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Nigam
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
authors.affiliation: Council of Scientific & Industrial Research-Institute of Genomics and Integrative Biology, Delhi, India.
authors.forename: M A Qadar
authors.initials: MA
authors.lastname: Pasha
mesh_terms: D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007194:India; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000235:genetics*; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D009765:Obesity / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D007328:Insulin; D002097:C-Reactive Protein