Comparison of several anthropometric measurements and blood lipid‑related indexes in metabolic-dysfunction associated fatty liver disease in adults: A cross-sectional study

Year 2024, Volume: 42 Issue: 1, 26 - 36, 27.02.2024

Hatice Merve Bayram , Raim İliaz Arda Öztürkcan , Bagnu Dundar , Fatma Esra Güneş

Abstract

Dyslipidemia is strongly related to metabolic-dysfunction associated fatty liver disease (MA-FLD). Therefore, the lipid profile may be a potential indicator of defining MAFLD. Anthro-pometric measurements are widely used as simple and practicable tools to screen metabolic dysfunction, and no study determined the relationship between anthropometric measurements and blood lipid-related indexes. The aim of this study was to examine the relationship between several anthropometric measurements and blood lipid-related indexes in MAFLD patients. This study was conducted among 123 MAFLD patients in a private University Hospital in Istanbul, Turkey, between 01.06.2021 – 30.12.2021. Anthropometric and biochemical measurements were taken from all patients. Hepatic steatosis was determined using ultrasonography. SPSS was used to analyze the data. Neck circumference (NC) was moderately associated with triglyceride glu-cose index (TyG) in both genders. It was found that there was a moderate correlation between NC and cardiometabolic index (CMI), triglyceride (TG), and triglyceride to high-density lipo-protein ratio (TG/HDL-C) in women, whereas it was weakly correlated with CMI index in men. Neck-to-height ratio (NHtR) was moderately associated with CMI, and TyG indexes in women, while it was weakly correlated with TyG index in men. There was a moderate association be-tween waist-to-hip ratio (WHR) and low-density lipoprotein (LDL-C) in women. However, it was only weakly correlated with CMI index in men. It was observed that the waist-to-height ratio (WHtR) was only linked with TyG index in men. Additionally, the body mass index (BMI) and blood lipid-related indicators had no association. Our finding suggests that both NC and NHtR could be used to predict the risk of dyslipidemia in MAFLD, especially among women.

Keywords

Metabolic-Dysfunction Associated Fatty Liver Disease, Anthropometric Measurements, Blood-Lipid Related Indexes

References

• REFERENCES
• [1] Eslam M, Sanyal AJ, George J; International Consensus Panel. MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology 2020;158:1999–2014.e1.
• [2] Bayram HM, Eren F, Gunes FE. The relationship between polyphenols and miRNAs: A novel therapeutic strategy for metabolic associated fatty liver disease. Hepatol Forum 2021;2:128–136. [CrossRef]
• [3] Estes C, Anstee QM, Arias-Loste MT, Bantel H, Bellentani S, Caballeria J, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol 2018;69:896–904. [CrossRef]
• [4] Younossi Z, Tacke F, Arrese M, Sharma BC, Mostafa I, Bugianesi E, et al. Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatol 2019;69:26722682. [CrossRef]
• [5] Cohen JC, Horton JD, Hobbs HH. Human fatty liver disease: Old questions and new insights. Sci 2011;332:1519–1523. [CrossRef]
• [6] Kawano Y, Cohen DE. Mechanisms of hepatic triglyceride accumulation in non-alcoholic fatty liver disease. J Gastroenterol 2013;48:434–441. [CrossRef]
• [7] Jian C, Xu Y, Ma X, Shen Y, Wang Y, Bao Y. Neck circumference is an effective supplement for nonalcoholic fatty liver disease screening in a community-based population. Int J Endocrinol 2020;2020:7982107. [CrossRef]
• [8] Bayram HM, Majoo FM, Ozturkcan A. Polyphenols in the prevention and treatment of non-alcoholic fatty liver disease: An update of preclinical and clinical studies. Clin Nutr ESPEN 2021;44:1– 14. [CrossRef]
• [9] Pappachan JM, Babu S, Krishnan B, Ravindran NC. Non-alcoholic fatty liver disease: A clinical update. J Clin Transl Hepatol 2017;5:384–393. [CrossRef]
• [10] European Association for the Study of the Liver; Clinical Practice Guideline Panel. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol 2021;75:659–689. [CrossRef]
• [11] Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al; American Gastroenterological Association; American Association for the Study of Liver Diseases; American College of Gastroenterologyh. The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterol 2012;142:1592–609. [CrossRef]
• [12] Katsiki N, Mikhailidis DP, Mantzoros CS. Non-alcoholic fatty liver disease and dyslipidemia: An update. Metab 2016;65:1109–1123. [CrossRef]
• [13] Amor AJ, Perea V. Dyslipidemia in nonalcoholic fatty liver disease. Curr Opin Endocrinol Diabetes Obes 2019;26:103–108. [CrossRef]
• [14] Wanless IR, Lentz JS. Fatty liver hepatitis (steatohepatitis) and obesity: An autopsy study with analysis of risk factors. Hepatol 1990;12:1106–1110. [CrossRef]
• [15] Zou Y, Zhong L, Hu C, Zhong M, Peng N, Sheng G. LDL/HDL cholesterol ratio is associated with new-onset NAFLD in Chinese non-obese people with normal lipids: A 5-year longitudinal cohort study. Lipids Health Dis 2021;20:28. [CrossRef]
• [16] Ren XY, Shi D, Ding J, Cheng ZY, Li HY, Li JS, et al. Total cholesterol to high-density lipoprotein cholesterol ratio is a significant predictor of nonalcoholic fatty liver: Jinchang cohort study. Lipids Health Dis 2019;18:47. [CrossRef]
• [17] Fukuda Y, Hashimoto Y, Hamaguchi M, Fukuda T, Nakamura N, Ohbora A, et al. Triglycerides to high‐density lipoprotein cholesterol ratio is an independent predictor of incident fatty liver; a population‐based cohort study. Liver Int 2016;36:713–720. [CrossRef]
• [18] Fan N, Peng L, Xia Z, Zhang L, Song Z, Wang Y, et al Triglycerides to high-density lipoprotein cholesterol ratio as a surrogate for nonalcoholic fatty liver disease: A cross-sectional study. Lipids Health Dis 2019;18:39. [CrossRef]
• [19] Lee SB, Kim MK, Kang S, Park K, Kim JH, Baik SJ, et al. Triglyceride glucose index is superior to the homeostasis model assessment of insulin resistance for predicting nonalcoholic fatty liver disease in Korean adults. Endocrinol Metab 2019;34:179–186. [CrossRef]
• [20] Wang J, Su Z, Feng Y, Xi R, Liu J, Wang P. Comparison of several blood lipid-related indexes in the screening of non-alcoholic fatty liver disease in women: A cross-sectional study in the Pearl River Delta region of southern China. BMC Gastroenterol 2021;21:482. [CrossRef]
• [21] Piché M, Poirier P, Lemieux I, Després J. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: An update. Prog Cardiovasc Dis 2018;61:103–113. [CrossRef]
• [22] Lin M, Lin T, Guo S, Tsai M, Chiang M, Huang T, et al. Waist-to-height ratio is a useful index for nonalcoholic fatty liver disease in children and adolescents: A secondary data analysis. BMC Public Health 2017;17:851. [CrossRef]
• [23] Sheng G, Xie Q, Wang R, Hu C, Zhong M, Zou Y. Waist-to-height ratio and non-alcoholic fatty liver disease in adults. BMC Gastroenterol 2021;21:239. [CrossRef]
• [24] Namazi N, Larijani B, Surkan PJ, Azadbakht L. The association of neck circumference with risk of metabolic syndrome and its components in adults: A systematic review and meta- analysis. Nutr Metab Cardiovasc Dis 2018;28:657–674. [CrossRef]
• [25] Saneei P, Shahdadian F, Moradi S, Ghavami A, Mohammadi H, Rouhani MH. Neck circumference in relation to glycemic parameters: A systematic review and meta-analysis of observational studies. Diabetol Metab Syndr 2019;11:50. [CrossRef]
• [26] Yang G, Yuan M, Wan G, Zhang X, Fu H, Yuan S, et al. Association between neck circumference and the occurrence of cardiovascular events in type 2 diabetes: Beijing Community Diabetes Study 20 (BCDS-20). Biomed Res Int 2019;2019:4242304. [CrossRef]
• [27] Bayram HM, Çelik ZM, Güneş FE. Neck circumference measurement in determining nutritional status and some nutrition-related diseases. Kafkas J Med Sci [Turkish] 2021;11:100–110. [CrossRef]
• [28] Huang B, Zhu M, Wu T, Zhou J, Liu Y, Chen X, et al. Neck circumference, along with other anthropometric indices, has an independent and additional contribution in predicting fatty liver disease. PLoS One 2015;10:e0118071. [CrossRef]
• [29] Mondal SA, Dutta D, Kumar M, Singh P, Basu M, Selvan C, et al. Neck circumference to height ratio is a reliable predictor of liver stiffness and nonalcoholic fatty liver disease in prediabetes. Indian J Endocrinol Metab 2018;22:347–354. [CrossRef]
• [30] Salmanroghani H, Salmanroghani R, Nourian M, Khayarn K, Lahmi F, Iravani S. Evaluation of neck circumference as an easy and reliable predictor for non-alcoholic fatty liver disease. Turkish J Gastroenterol 2019;30:163–170. [CrossRef]
• [31] Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol 2020;7,3:202–209. [CrossRef]
• [32] Yajima Y, Ohta K, Narui T, Abe R, Suzuki H, Ohtsuki M. Ultrasonographical diagnosis of fatty liver: Significance of the liver-kidney contrast. Tohoku J Exp Med 1983;139:43–50. [CrossRef]
• [33] Pekcan G. Beslenme durumunun saptanması. 2nd ed. Ankara: Reklam Kurdu Ajansı; 2008.
• [34] WHO. Body mass index - BMI, 2004. Available at: https://web.archive.org/web/20141129093407/https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy- lifestyle/body-mass-index-bmi. Accessed Feb 05, 2024.
• [35] Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: Insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetol 1985;28:412–419. [CrossRef]
• [36] Wakabayashi I, Daimon T. The cardiometabolic index as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta 2015;438:274– 278. [CrossRef]
• [37] Zhang S, Du T, Zhang J, Lu H, Lin X, Xie J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis 2017;16:15. [CrossRef]
• [38] Kim-Dorner S, Deuster PA, Zeno SA, Remaley AT, Poth M. Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance? Metabol 2010;59:299–304. [CrossRef]
• [39] Young KA, Maturu A, Lorenzo C, Langefeld CD, Wagenknecht LE, Chen YI, et al. The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a predictor of insulin resistance, β-cell function, and diabetes in Hispanics and African Americans. J Diabetes Complications 2019;33:118–122. [CrossRef]
• [40] Fujii H, Kawada N; Japan Study Group of NAFLD. The role of insulin resistance and diabetes in nonalcoholic fatty liver disease. Int J Mol Sci 2020;21:3863. [CrossRef]
• [41] Donnelly KL, Smith CI, Schwarzenberg SJ, Jessurun J, Boldt MD, Parks EJ. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. J Clin Invest 2005;115:1343–1351. [CrossRef]
• [42] Simental-Mendia LE, Simental-Mendia E, Rodriguez-Hernandez H, Rodriguez-Moran M, Guerrero-Romero F. The product of triglycerides and glucose as biomarker for screening simple steatosis and NASH in asymptomatic women. Ann Hepatol 2016;15:715–720
• [43] Kitae A, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. The triglyceride and glucose index is a predictor of incident nonalcoholic fatty liver disease: A population-based cohort study. Canadian J Gastroenterol Hepatol 2019;2019:5121574. [CrossRef]
• [44] van der Poorten D, Milner K, Hui J, Hodge A, Trenell MI, Kench JG, et al. Visceral fat: A key mediator of steatohepatitis in metabolic liver disease. Hepatol 2008;48:449–57. [CrossRef]