Department of Internal Medicine, Division of Endocrinology, Korea University College of Medicine, Seoul, Korea.
Liver Int. 2010 Sep;30(8):1189-96. doi: 10.1111/j.1478-3231.2010.02300.x. Epub 2010 Jun 29.
BACKGROUND/AIMS: Abdominal obesity is associated with metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). Although there have been many studies to determine the optimal cutoff points of waist circumference or visceral fat area in screening for metabolic syndrome, there have been no reports to establish adequate cutoff points of abdominal obesity indices in screening for NAFLD. Therefore, we examined the appropriate cutoff points of abdominal obesity indices associated with NAFLD in Korean men and women using receiver operating characteristic (ROC) curve analysis. Furthermore, we compared the usefulness of various abdominal obesity indices measured using computed tomography (CT), dual-energy X-ray absorptiometry (DXA) and anthropometric parameters for detecting NAFLD. METHODS: We analysed the baseline data of an ongoing prospective, observational cohort study, including a total of 456 healthy subjects 20-88 years of age. NAFLD was diagnosed by unenhanced CT using the liver attenuation index. RESULTS: All ROC curves of waist circumference, waist-to-height ratio, DXA-measured trunk fat mass and CT-measured visceral fat area were significantly above the diagonal line. There were no significant differences in the area under the curve values among these abdominal obesity indices in each gender. The appropriate cutoff point of waist circumference in screening for NAFLD was 89 cm for men and 84 cm for women and the optimal cutoff point of waist-to-height ratio was 0.52 for men and 0.53 for women with very high negative predictive values. CONCLUSIONS: The simple anthropometric parameters, such as waist circumference and waist-to-height ratio, are as useful as DXA and CT for predicting NAFLD in Korean adults.
背景/目的:腹部肥胖与代谢综合征和非酒精性脂肪肝(NAFLD)有关。虽然有许多研究旨在确定腰围或内脏脂肪面积的最佳截断点以筛查代谢综合征,但尚未有报告确定筛查 NAFLD 时腹部肥胖指数的适当截断点。因此,我们使用受试者工作特征(ROC)曲线分析,检查了与韩国男性和女性 NAFLD 相关的腹部肥胖指数的适当截断点。此外,我们比较了使用计算机断层扫描(CT)、双能 X 射线吸收法(DXA)和人体测量参数测量的各种腹部肥胖指数在检测 NAFLD 方面的有用性。
方法:我们分析了一项正在进行的前瞻性观察性队列研究的基线数据,该研究共纳入了 456 名年龄在 20-88 岁的健康受试者。NAFLD 通过使用肝衰减指数的非增强 CT 进行诊断。
结果:所有腰围、腰高比、DXA 测量的躯干脂肪量和 CT 测量的内脏脂肪面积的 ROC 曲线均明显高于对角线。在每个性别中,这些腹部肥胖指数的曲线下面积值之间没有显著差异。筛查 NAFLD 的腰围最佳截断点为男性 89cm,女性 84cm,腰围与身高比的最佳截断点为男性 0.52,女性 0.53,具有非常高的阴性预测值。
结论:简单的人体测量参数,如腰围和腰高比,与 DXA 和 CT 一样可用于预测韩国成年人的 NAFLD。
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