Body mass index and waist circumference in non-alcoholic fatty liver disease

Abstract

Objective To evaluate the association of anthropometric indexes (body mass index and waist circumference) in patients with non-alcoholic fatty liver disease (NAFLD), and its association with insulin resistance (IR), metabolic syndrome (MS) and histological findings. Methods From August 2003 to July 2004 a case series of 81 outpatients with clinic and/or histological diagnosis of NAFLD were selected at the Bahia University Gastro-Hepatology Clinic, Brazil. Liver function tests, lipid profile, glucose and insulin were performed in all patients. Body mass index (BMI) and waist circumference (WC) were determined according to WHO criteria. IR was measured by means of the homeostasis model assessment (HOMA) and IR was considered with HOMA ≥3. MS was defined according to the Adult Treatment Panel III (ATP III). Liver biopsy was performed in 37 cases. Results Body mass index ≥ 30 kg m−2 (obesity) was found in 39% of the cases and BMI ≥ 25–29.9 kg m−2 (overweight) in 53%. BMI was correlated with IR (r = 0.29; P = 0.02) and WC with ALT (r = 0.02; P = 0.03). Increased WC also was related to IR and to MS. The presence of steatohepatitis with fibrosis on liver biopsy was associated with overweight (68%) and increase of WC (41%). Conclusions Body mass index and WC are frequent associated with MS, IR and histological findings (steatohepatitis and fibrosis) in patients with NAFLD.