Epidemiology

Body fat distribution influences liver fibrosis

Last Updated: 2010-09-24 12:45:12 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Fibrosis stage in nonalcoholic fatty liver disease is linked with how much peripheral and abdominal fat a patient has, researchers have found.

Even after adjustment for other factors, "liver fibrosis was significantly associated with regional body sizes -- the extremities and abdomen -- in a gender- and menopausal-specific manner," lead author Dr. Ayako Suzuki told Reuters Health by email.

Dr. Suzuki of Duke University, Durham, North Carolina, and colleagues report in an August 23rd online paper in Clinical Gastroenterology and Hepatology on a cross-sectional analysis of regional anthropomorphic measures in 537 patients. Their mean age was 48 years; their mean body mass index - 34.6 -- was in the obese range.

The authors defined peripheral adipose depot size (extremity size) as the sum of z-scores of the middle upper arm circumference and hip circumference, relative to total body size. They defined abdominal adipose depot size as waist circumference.

The prevalence of advanced fibrosis (stage 3 or 4) varied significantly and was highest in postmenopausal women (36.1%). For men, the prevalence was 17.7 % and for pre-menopausal women, it was 13.5%.

Furthermore, men with smaller extremity size (i.e., with larger abdominal girth), pre-menopausal women with larger extremity size, and post-menopausal women with larger abdominal size were more likely to have higher stages of fibrosis. This was after adjustment for caloric intake and energy expenditure.

"This implies that body fat distribution in conjunction with gender- and menopause-associated factors may impact the disease severity of nonalcoholic fatty liver disease," Dr. Suzuki said.

"A better understanding of underlying mechanisms warrants further investigation," she concluded, "as this may allow for a 'tailored' patient-specific treatment plan for those with nonalcoholic fatty liver disease in the future."

SOURCE: http://link.reuters.com/pav35p

Clin Gastroenterol Hepatol 2010.