Top reports on obesity and liver health for 2017
Obesity, being overweight and increased BMI are risk factors for steatohepatitis and metabolic liver disease such as nonalcoholic fatty liver disease that can lead to nonalcoholic steatohepatitis and hepatocellular carcinoma.
Recent reports on obesity and liver disease include study results on diet to lower liver disease risks, visceral fat and waist-to-calf circumference as predictive factors for fatty liver, and advise on physical activity to prevent fatty liver disease.
Below, Healio.com/Hepatology has compiled a list of some of the most relevant reports on obesity and liver health for 2017.
Obesity correlates with discordance in noninvasive tests for fibrosis
Compared with biopsy results for fibrosis, BMI in the obesity range correlated with discordance between magnetic resonance elastography and transient elastography among patients with nonalcoholic fatty liver disease, according to recently published data. Further, discordance increased proportional with increased BMI.
“We are trying to see when vibration-controlled transient elastography can provide a reading that would be concordant with MRE so in those circumstances we can just use vibration-controlled transient elastography — a cheaper test — and then utilize MRE in cases when vibration-controlled transient elastography is not likely to be concordant with MRE,” Rohit Loomba, MD, MHSc, director of the NAFLD Research Center, UC San Diego Health, and professor of medicine at UC San Diego School of Medicine, told Healio.com/Hepatology. “This study tries to tease that out to help the clinician and also move the field forward towards an integrated approach of using various imaging modalities for the assessment of fibrosis in NAFLD.” Read more
Sugar-to-starch exchange diet decreases liver fat in pediatric obesity
Isocaloric fructose restriction in children with obesity showed a decrease in liver fat, visceral fat and de novo lipogenesis and improved insulin kinetics after a 9-day diet, according to recently published data.
“The improvements in these outcome measures occurred irrespective of baseline liver fat content or weight change,” Jean-Marc Schwarz, PhD, from the Touro University, California, and colleagues wrote. “These short-term data support an intervention focusing on fructose restriction as an approach to both combat [nonalcoholic fatty liver disease] and improve insulin kinetics.” Read more
Obesity, prior surgeries increase risk for hepatic steatosis in IBD
The prevalence of hepatic steatosis in patients with inflammatory bowel disease ranges, but occurs more often among those with obesity or metabolic syndrome and those with previous surgeries, according to a poster presentation at Advances in IBD 2017.
According to the investigators, prior research suggested an increased prevalence of hepatic steatosis in IBD, potentially related to chronic inflammation, drug-induced hepatotoxicity, malnutrition, intestinal dysbiosis and previous surgeries. Read more
Regular physical activity may reduce NAFLD in adults with overweight, obesity
In adults with overweight or obesity, daily, habitual physical activity — even if not moderate to vigorous intensity — reduced nonalcoholic fatty liver disease, according to findings presented at the European Congress on Obesity.
“In these individuals, sedentary behavior and daily step counts are important determinants of the amount of liver fat and, in turn, of metabolic health status,” Kelly Bowden-Davies, MSc, a PhD student at the Institute of Ageing and Chronic Disease at the University of Liverpool, United Kingdom, and colleagues said in a press release. “These findings reinforce the role of avoiding sedentary behavior even in the absence of increased [moderate to vigorous physical activity].” Read more
Higher waist-to-calf ratios linked to fatty liver risk, muscle loss
Results from a recent study of patients with type 2 diabetes showed that higher waist-to-calf ratios increased the risk for nonalcoholic fatty liver disease, fibrosis and sarcopenia, independent of insulin resistance.
“Loss of skeletal muscle mass, reduced strength and increasing fat mass often associated with aging can induce insulin resistance and increase risk of developing obesity-related comorbidities such as NAFLD and diabetes,” the researchers wrote. “As sarcopenic obesity is strongly related to cardiometabolic disease, estimation of abdominal fat and leg mass by measuring waist-to-calf circumference ratio may be a useful index that simply indicates sarcopenic obesity.” Read more
Obesity, hepatitis C epidemics drive ‘alarming’ increase in liver cancer incidence, mortality
A SEER analysis published this summer revealed staggering statistics about liver cancer in the United States.
Incidence has increased steadily since the mid-1970s, and that trend is expected to continue until at least 2030, according to the report by Islami and colleagues, published in CA: A Cancer Journal for Clinicians. Read more
Visceral obesity raises risk for NASH in lean, obese patients with NAFLD
In a comparative study of overweight-to-obese patients vs. lean patients with nonalcoholic fatty liver disease, researchers found an association between waist circumference and nonalcoholic steatohepatitis in both groups. They also observed an association among a variant in the PNPLA3 gene and both NASH and fibrosis in lean patients.
“In the present study, we analyzed in a large series of Caucasian patients with biopsy-proven NAFLD the possible differences between lean NAFLD, which reflects ‘normal weight obesity,’ and overweight/obese NAFLD and investigated the role of visceral obesity,” Anna Ludovica Fracanzani, MD, from the University of Milan, Italy, and colleagues wrote. “In lean NAFLD, the only independent variable associated with NASH and significant fibrosis ... was the GG PNPLA3 polymorphism, confirming the role of genetic predisposition in patients with only minor metabolic alterations.” Read more