Toronto General Hospital, University Health Network, Toronto, Canada.
Tawam Hospital, Abu Dhabi Health Authority, Abu Dhabi, United Arab Emirates.
Nutrition. 2022 Jan;93:111491. doi: 10.1016/j.nut.2021.111491. Epub 2021 Sep 20.
Non-alcoholic fatty liver disease is a leading cause of liver disease worldwide and includes nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Because NASH is associated with obesity severity, routine evaluation of obesity/body fat in clinical settings may help detect patients at risk. The aim of this study was to determine whether assessing body fat by bioelectrical impedance analysis (BIA) is superior to body mass index (BMI) and waist circumference (WC) in assessing the risk for NASH.
In this cross-sectional study, patients were recruited and gave consent from a local hospital. All had a liver biopsy. Measurements before the biopsy included BMI, WC, and BIA. BIA was used to measure percentage body fat and fat mass (kg). Based on histology, patients were grouped into one of three categories: simple steatosis (SS), NASH, or normal liver (NL).
Of the 139 participants who participated, 39 were classified as SS, 53 as NASH, and 47 as NL. Regardless of sex, patients with NASH had significantly higher BMI, WC, percentage body fat and fat mass than those with NL or SS. These four parameters were significantly positively correlated with liver histology measurements. In all patients, when controlling for sex and age we found that BMI, WC, and BIA were equal at predicting the presence of NASH (P = 0.0571).
All three methods, BIA, BMI, and WC, were comparable in assessing the risk for NASH. For practical purpose in clinical settings, using BMI is acceptable.
非酒精性脂肪性肝病是全球范围内导致肝病的主要原因,包括非酒精性脂肪性肝炎(NASH),其可进展为肝硬化。由于 NASH 与肥胖严重程度相关,因此在临床环境中常规评估肥胖/体脂肪可能有助于发现处于危险中的患者。本研究旨在确定生物电阻抗分析(BIA)评估体脂肪是否优于体重指数(BMI)和腰围(WC)评估 NASH 的风险。
在这项横断面研究中,从当地医院招募并获得了患者的同意。所有患者均接受了肝活检。活检前的测量包括 BMI、WC 和 BIA。BIA 用于测量体脂肪百分比和脂肪量(kg)。根据组织学,患者被分为单纯性脂肪变性(SS)、NASH 或正常肝脏(NL)之一。
共有 139 名参与者参加了研究,其中 39 名被归类为 SS,53 名被归类为 NASH,47 名被归类为 NL。无论性别如何,患有 NASH 的患者的 BMI、WC、体脂肪百分比和脂肪量均明显高于 NL 或 SS 患者。这四个参数与肝脏组织学测量呈显著正相关。在所有患者中,当控制性别和年龄时,我们发现 BMI、WC 和 BIA 在预测 NASH 的存在方面具有同等的预测价值(P=0.0571)。
BIA、BMI 和 WC 这三种方法在评估 NASH 的风险方面具有可比性。出于临床实践的目的,使用 BMI 是可以接受的。