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Body composition among adults at a healthy body mass index and association with undetected non-alcoholic fatty liver

International Journal of Obesity volume 46, pages 1403–1405 (2022)Cite this article

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Abstract

Background

Adults with a healthy Body Mass Index but elevated body fat are at risk for a variety of undetected metabolic problems. It is unclear whether non-alcoholic fatty liver is associated with this body type.

Participants/Methods

Associations between elevated body fat and non-alcoholic fatty liver disease (NAFLD) among adults with a healthy Body Mass Index (18.5–24.9) were assessed. A cohort of healthy BMI, non-pregnant, adults without history of liver disease or recent heavy drinking was constructed from the NHANES 2017–2018 survey. Body fat percentages were determined from whole-body DXA scans. Liver ultrasound transient elastography indicated the presence of hepatic steatosis.

Results

A significantly larger proportion of adults with an elevated body fat % (46.2%) than those with a healthy body fat % (25.1%) (p = 0.002) had undiagnosed NAFLD. In a logistic regression adjusted for age, sex, race/ethnicity, and exercise, hepatic steatosis was associated with an elevated body fat percentage within the cohort of adults with a healthy BMI (OR 3.51; 95% CI 2.11–5.86).

Conclusion

The usefulness of alternative body composition measures should be considered when screening for NAFLD.

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Data availability

The NHANES is a publicly accessible de-identified dataset. All of the data used in this study can be found at https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2017.

References

  1. Grover SA, Kaouache M, Rempel P, Joseph L, Dawes M, Lau DC, et al. Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study. Lancet Diabetes Endocrinol. 2015;3:114–22.

    Article  Google Scholar 

  2. Milić S, Lulić D, Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations. World J Gastroenterol. 2014;20:9330–7.

    PubMed  PubMed Central  Google Scholar 

  3. Mainous AG 3rd, Tanner RJ, Jo A, Anton SD. Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend. Ann Fam Med. 2016;14:304–10.

    Article  Google Scholar 

  4. Wee CC, Hamel MB, Huang A, Davis RB, Mittleman MA, McCarthy EP. Obesity and undiagnosed diabetes in the U.S. Diabetes Care. 2008;31:1813–5. https://doi.org/10.2337/dc07-1867.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014;56:426–33.

    Article  Google Scholar 

  6. Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011;9:524–e1. Junquiz e60

    Article  Google Scholar 

  7. Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol. 2019;71:793–801.

    Article  Google Scholar 

  8. Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. Int J Epidemiol. 2014;43:655–65.

    Article  Google Scholar 

  9. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.

  10. National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking Accessed 11 April, 2022.

  11. Ferraioli G, Wong VW, Castera L, Berzigotti A, Sporea I, Dietrich CF, et al. Liver Ultrasound Elastography: an Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound Med Biol. 2018;44:2419–40.

    Article  Google Scholar 

  12. da Silva LCM, de Oliveira JT, Tochetto S, de Oliveira CPMS, Sigrist R, Chammas MC. Ultrasound elastography in patients with fatty liver disease. Radiol Bras. 2020;53:47–55.

    Article  Google Scholar 

  13. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf Accessed 11 April, 2022.

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Authors and Affiliations

  1. Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States

    Arch G. Mainous III, Benjamin J. Rooks, James F. Medley & Samuel B. Dickmann

  2. Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL, United States

    Arch G. Mainous III

Authors
  1. Arch G. Mainous III
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  2. Benjamin J. Rooks
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  3. James F. Medley
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  4. Samuel B. Dickmann
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Contributions

AM—supervision, conceptualization, visualization, writing-original draft preparation, writing-review, and editing. BR—data curation, formal analysis, conceptualization, writing-original draft preparation, writing-review, and editing. JM—conceptualization, writing-original draft preparation, writing-review, and editing. SD—conceptualization, writing-original draft preparation, writing-review, and editing.

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Correspondence to Arch G. Mainous III.

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Mainous, A.G., Rooks, B.J., Medley, J.F. et al. Body composition among adults at a healthy body mass index and association with undetected non-alcoholic fatty liver. Int J Obes 46, 1403–1405 (2022). https://doi.org/10.1038/s41366-022-01124-0

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