Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
Clin Transl Gastroenterol. 2021 Feb 17;12(2):e00300. doi: 10.14309/ctg.0000000000000300.
Visceral adipose tissue (VAT) has been found to play a critical role in the development of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) independent of generalized obesity.
In this secondary study of prospectively acquired data, 625 participants underwent magnetic resonance spectroscopy and chemical shift fat-water separation MRI (2-point Dixon) of the liver and whole abdomen, respectively, in a 3 Tesla magnet. Whole abdominal VAT and subcutaneous adipose tissue (SAT) were extracted from the 2-point Dixon image series using an automated method. Clinical/anthropometric/blood biochemistry parameters were measured. Using region-specific body mass index, participants were classified into 3 paired subgroups (lean, overweight, and obese) and presence of NAFLD (liver fat content ≥ 5.5%).
All relevant clinical/anthropometric/blood biochemistry characteristics and liver enzymes were statistically significant between groups (P < 0.001). NAFLD was found in 12.1%, 43.8%, and 68.3% and metabolic syndrome in 51.1%, 61.9%, and 65% of the lean, overweight, and obese, respectively. Odds ratio for metabolic syndrome and NAFLD was increased by 2.73 (95% confidence interval [CI] 2.18-3.40) and 2.53 (95% CI 2.04-3.12), respectively, for 1SD increase in VAT volume while prevalence of metabolic syndrome was increased by 2.26 (95% CI 1.83-2.79) for 1SD increase in liver fat content (%). VAT/SAT ratio in the lean with fatty liver showed the highest ratio (0.54) among all the subgroups, without a significant difference between the lean and obese with NAFLD (P = 0.127).
Increased VAT volume/disproportional distribution of VAT/SAT may be vital drivers to the development of metabolic syndrome and NAFLD irrespective of body mass index category.
内脏脂肪组织（VAT）已被发现独立于全身性肥胖在代谢综合征和非酒精性脂肪性肝病（NAFLD）的发展中起着关键作用。
在这项前瞻性采集数据的二次研究中，625 名参与者在 3T 磁体上分别进行了肝脏磁共振波谱和化学位移水脂分离磁共振成像（2 点 Dixon）。使用自动方法从 2 点 Dixon 图像系列中提取全腹 VAT 和皮下脂肪组织（SAT）。测量临床/人体测量/血液生化参数。使用特定区域的体重指数，将参与者分为 3 个配对亚组（瘦、超重和肥胖）和存在 NAFLD（肝脏脂肪含量≥5.5%）。
所有相关的临床/人体测量/血液生化特征和肝酶在组间均具有统计学意义（P < 0.001）。分别在 12.1%、43.8%和 68.3%的瘦、超重和肥胖者中发现了 NAFLD，在 51.1%、61.9%和 65%的瘦、超重和肥胖者中发现了代谢综合征。VAT 体积每增加 1SD，代谢综合征和 NAFLD 的优势比分别增加 2.73（95%置信区间 [CI] 2.18-3.40）和 2.53（95% CI 2.04-3.12），而肝脏脂肪含量每增加 1SD，代谢综合征的患病率增加 2.26（95% CI 1.83-2.79）。在所有亚组中，患有脂肪肝的瘦者的 VAT/SAT 比值最高（0.54），而患有 NAFLD 的瘦者和肥胖者之间没有显著差异（P = 0.127）。
VAT 体积的增加/不成比例的 VAT/SAT 分布可能是代谢综合征和 NAFLD 发展的重要驱动因素，而与体重指数类别无关。
