Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México.
Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico.
PLoS One. 2024 Feb 23;19(2):e0298662. doi: 10.1371/journal.pone.0298662. eCollection 2024.
The aim was to evaluate the effect different types of abdominal fat have on NAFLD development and the effects of abdominal fat has on the association between Metabolic Syndrome (MetS) and NALFD.
Data was collected from the cross-sectional NHANES dataset (2017-2018 cycle). Using the controlled attenuation parameter (USG CAP, dB/m), which measures the level of steatosis, the cohort was stratified into two groups: NAFLD(+) (≥274 dB/m) and NAFLD(-). Using complex samples analyses, associations between liver steatosis or NAFLD and types of abdominal fat area [Total abdominal (TAFA), subcutaneous (SAT), and visceral (VAT)] were determined. Pearson's correlation coefficient (r) was calculated to evaluate the associations between adipose tissues and NAFLD. Logistic regression was used to determine the risk [odds ratio (OR) and 95% confidence interval (95%CI)]. Participants were also classified by MetS, using the Harmonizing Definition criteria.
Using 1,980 participants (96,282,896 weighted), there was a significant (p<0.001) correlation between USG CAP and TAFA (r = 0.569), VAT (r = 0.645), and SAT (r = 0.479). Additionally, the risk of developing NAFLD was observed for total abdominal obesity (OR = 19.9, 95%CI: 5.1-77.8, p<0.001), visceral obesity (OR = 9.1, 95%CI: 6.2-13.5, p<0.001) and subcutaneous obesity (OR = 4.8, 95%CI: 3.2-6.9, p<0.001). Using 866 participants (44,399,696 weighted), for visceral obesity, participants with MetS and visceral obesity (OR = 18.1, 95%CI: 8.0-41.3, p<0.001) were shown to have a greater risk than participants with MetS only (OR = 6.3, 95%CI: 2.6-15.2, p<0.001). For subcutaneous obesity, again, participants with MetS and subcutaneous obesity (OR = 18.3, 95%CI: 8.0-41.9, p<0.001) were shown to have a greater risk than the MetS-only group (OR = 10.3, 95%CI: 4.8-22.4, p<0.001).
TAFA, VAT, and SAT were positively associated with USG CAP values and increased the risk of developing NAFLD. Also, the type of abdominal fat depots did affect the association between MetS and NAFLD.
本研究旨在评估不同类型的腹部脂肪对非酒精性脂肪性肝病（NAFLD）发展的影响，以及腹部脂肪对代谢综合征（MetS）与 NAFLD 之间关联的影响。
本研究数据来自于横断面 NHANES 数据集（2017-2018 周期）。使用控制衰减参数（USG CAP，dB/m）来衡量脂肪变性的程度，将队列分为两组：NAFLD（+）（≥274 dB/m）和 NAFLD（-）。采用复杂样本分析，确定肝脂肪变性或 NAFLD 与腹部脂肪区类型[总腹部（TAFA）、皮下（SAT）和内脏（VAT）]之间的关联。使用皮尔逊相关系数（r）评估脂肪组织与 NAFLD 之间的相关性。采用 logistic 回归确定风险[比值比（OR）和 95%置信区间（95%CI）]。还使用 Harmonizing 定义标准将参与者分类为代谢综合征。
使用 1980 名参与者（96282896 人加权），USG CAP 与 TAFA（r=0.569）、VAT（r=0.645）和 SAT（r=0.479）之间存在显著相关性（p<0.001）。此外，总腹部肥胖（OR=19.9，95%CI：5.1-77.8，p<0.001）、内脏肥胖（OR=9.1，95%CI：6.2-13.5，p<0.001）和皮下肥胖（OR=4.8，95%CI：3.2-6.9，p<0.001）与发生 NAFLD 的风险相关。使用 866 名参与者（44399696 人加权），对于内脏肥胖，患有代谢综合征和内脏肥胖的参与者（OR=18.1，95%CI：8.0-41.3，p<0.001）比仅患有代谢综合征的参与者（OR=6.3，95%CI：2.6-15.2，p<0.001）风险更高。对于皮下肥胖，同样，患有代谢综合征和皮下肥胖的参与者（OR=18.3，95%CI：8.0-41.9，p<0.001）比仅患有代谢综合征的参与者（OR=10.3，95%CI：4.8-22.4，p<0.001）风险更高。
TAFA、VAT 和 SAT 与 USG CAP 值呈正相关，并增加了发生 NAFLD 的风险。此外，腹部脂肪储存类型确实影响了代谢综合征与 NAFLD 之间的关联。
