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09-12-2010 | Cardiometabolic | Article

Visceral fat accumulation influences pathogenesis of NAFLD

Abstract

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MedWire News: Japanese researchers say that excessive visceral fat accumulation might influence the preclinical development and later progression of nonalcoholic fatty liver disease (NAFLD).

"Visceral fat accumulation exacerbates hepatic fibrosis in NAFLD patients, leads to elevation of the serum alanine aminotransferase (ALT) level, and is involved in the preclinical onset of NAFLD, even in the healthy general population," the team reports.

Yuichiro Eguchi (Saga Medical School, Japan) and colleagues evaluated the relationship between visceral fat accumulation, measured with a bioelectrical impedance analyzer (XSCAN; Owa Medical, Fukuoka, Japan), and biochemical parameters in 550 patients (20-75 years) who received a health checkup between April 2009 and March 2010.

A further 74 patients with NAFLD who had undergone a liver biopsy were retrospectively reviewed to evaluate the relationship between visceral fat accumulation and the histopathological progression of NAFLD.

There was a significant positive relationship between visceral fat accumulation and body mass index (BMI), low-density lipoprotein (LDL) cholesterol, triglycerides, glucose, blood pressure, and liver enzymes, including aspartate aminotransferase (AST) and ALT, and a negative association with high-density lipoprotein (HDL) cholesterol.

The researchers show that visceral fat accumulation, triglycerides, and LDL cholesterol were associated with serum ALT (a cytosolic component of hepatocytes) in a continuous manner.

In the liver biopsy analysis, histopathological activity, as determined by the NAFLD activity score (NAS) and Brunt's classification, was not correlated with visceral fat area (VFA).

However, visceral fat accumulation was related to the progression of nonalcoholic steatohepatitis (NASH); VFA in NAFLD patients with advanced NASH (stage 2-4 fibrosis) was greater than that in patients with early NASH (stage 0 or 1 fibrosis).

"Visceral fat accumulation continuously influences the histological changes in NAFLD from the beginning of fat deposition in hepatocytes to the development of NASH," Eguchi and team say.

"The pathogenic role of visceral fat accumulation in NAFLD means that it could be a potential target for the treatment of NASH/NAFLD," they add.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Nikki Withers