- 作者：Ayako Suzuki?/sup> ; suzuk004@mc.duke.edu ; Manal F. Abdelmalek?/sup> ; Aynur Unalp– ; Arida&Dagger ; ; Katherine Yates&Dagger ; ; Arun Sanyal§ ; ; Cynthia Guy?/sup> ; Anna Mae Diehl?/sup>
- 关键词：Obesity ; Regional Anthropometrics ; Gender Difference ; Reproductive Status
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2010
- 出版时间：December 2010
- 年：2010
- 卷：8
- 期：12
- 页码：1062-1069
- 全文大小：655 K
Background & Aims
In overnourished individuals, impaired peripheral fat storage (ie, reduced fat mass in extremities) can increase delivery of surplus calories to the organs other than peripheral adipose tissues, including the liver (ie, lipid overload), and facilitate disease progression in patients with nonalcoholic fatty liver disease (NAFLD). We investigated whether peripheral and/or abdominal adipose depot size correlates with stage of hepatic fibrosis in patients with NAFLD in sex- and/or menopausal stage¨Cspecific manners.Methods
We performed a cross-sectional analysis of 537 adult patients with NAFLD. Peripheral adipose depot size was defined as the sum of z-scores of 2 anthropometric parameters (middle upper arm circumference and hip circumference, relative to total body size) and expressed as extremity size. Abdominal adipose depot size was defined as waist circumference. Peripheral and abdominal adipose depot sizes were associated with fibrosis stage(s) (F0¨CF4) using multivariable analyses separately for men and pre- and post-menopausal women.
Results
After adjusting for caloric intake and energy expenditure during physical activity (MET; hours/week), peripheral and/or abdominal adipose depot sizes were differentially associated with fibrosis stages in men and pre- and post-menopausal women. Men with smaller extremity size, premenopausal women with larger extremity size, and postmenopausal women with larger abdominal size were more likely to have higher stages of fibrosis.
Conclusions
In patients with NAFLD, regional anthropometric measures are associated with fibrosis severity in a sex- and menopausal stage¨Cspecific manner. Unlike premenopausal women, men with NAFLD who have small peripheral adipose depots are at an increased risk of having advanced fibrosis.