亚洲人非酒精性脂肪性肝病患者中，区分消瘦与超重/肥胖状态的内脏脂肪面积性别特异性临界值
Sex-specific Cutoff Values of Visceral Fat Area for Lean vs. Overweight/Obese Nonalcoholic Fatty Liver Disease in Asians.
作者信息
Lee Sunyoung, Kim Kyoung Won, Lee Jeongjin
机构信息
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
出版信息
J Clin Transl Hepatol. 2022 Aug 28;10(4):595-599. doi: 10.14218/JCTH.2021.00379. Epub 2022 Jan 7.
BACKGROUND AND AIMS
Visceral obesity is a risk factor for nonalcoholic fatty liver disease (NAFLD). We investigated sex-specific optimal cutoff values for visceral fat area (VFA) associated with lean and overweight/obese NAFLD in an Asian population.
METHODS
This retrospective study included 678 potential living liver donors (mean age, 30.8±9.4 years; 434 men and 244 women) who had undergone abdominal computed tomography (CT) imaging and liver biopsy between November 2016 and October 2017. VFA was measured using single-slice abdominal CT. NAFLD was evaluated by liver biopsy (≥5% hepatic steatosis). Receiver operating characteristic curve analysis was used to determine cutoff values for VFA associated with lean (body mass index [BMI] <23 kg/m) and overweight/obese (BMI ≥23 kg/m) NAFLD.
RESULTS
Area under the curve (AUC) values with 95% confidence intervals (CI) for VFA were 0.82 (95% CI, 0.75-0.88) for lean and 0.74 (95% CI, 0.69-0.79) for overweight/obese men with NAFLD. The AUC values were 0.67 (95% CI, 0.58-0.75) for lean and 0.71 (95% CI, 0.62-0.80) for overweight/obese women with NAFLD. The cutoff values for VFA associated with lean NAFLD were 50.2 cm in men and 40.5 cm in women. The optimal cutoff values for VFA associated with overweight/obese NAFLD were 100.6 cm in men and 68.0 cm in women.
CONCLUSIONS
Sex-specific cutoff values for VFA may be useful for identifying subjects at risk of lean and overweight/obese NAFLD.
背景与目的
内脏肥胖是非酒精性脂肪性肝病（NAFLD）的一个风险因素。我们在亚洲人群中研究了与非肥胖和超重/肥胖NAFLD相关的内脏脂肪面积（VFA）的性别特异性最佳截断值。
方法
这项回顾性研究纳入了678名潜在的活体肝脏供体（平均年龄30.8±9.4岁；434名男性和244名女性），他们在2016年11月至2017年10月期间接受了腹部计算机断层扫描（CT）成像和肝脏活检。使用单层腹部CT测量VFA。通过肝脏活检（肝脂肪变性≥5%）评估NAFLD。采用受试者操作特征曲线分析来确定与非肥胖（体重指数[BMI]<23kg/m²）和超重/肥胖（BMI≥23kg/m²）NAFLD相关的VFA截断值。
结果
非肥胖男性NAFLD患者VFA的曲线下面积（AUC）值及95%置信区间（CI）为0.82（95%CI,0.75 - 0.88），超重/肥胖男性为0.74（95%CI,0.69 - 0.79）；非肥胖女性NAFLD患者VFA的AUC值及95%CI为0.67（95%CI,0.58 - 0.75），超重/肥胖女性为0.71（95%CI,0.62 - 0.80）。与非肥胖NAFLD相关的VFA截断值男性为50.2cm²，女性为40.5cm²。与超重/肥胖NAFLD相关的VFA最佳截断值男性为100.6cm²，女性为68.0cm²。
结论
VFA的性别特异性截断值可能有助于识别非肥胖和超重/肥胖NAFLD风险人群。
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