| Abstract: | BACKGROUND: Few population-based studies investigated the association between body fat distribution and the risk of nonalcoholic fatty liver disease (NAFLD) and significant liver fibrosis. OBJECTIVE: To evaluate the relationship between total body fat and body fat distribution and NAFLD in the general US population. METHODS: This is a cross-sectional, population-based study based on the 2017-2018 cycle of the National Health and Nutrition Examination Survey. Participants aged 18-59 without known liver conditions or significant alcohol consumption were studied by dual energy x-ray absorptiometry (DXA) and vibration controlled transient elastography (VCTE) to assess body composition and liver steatosis and fibrosis, respectively. Multivariable logistic regression analysis was performed to evaluate the contribution of body mass index (BMI) and android/gynoid ratio (A/G ratio) on the prevalence of liver steatosis and fibrosis in males and females. RESULTS: Weighted prevalence of steatosis were 41.5% and 29.9% among the 1115 and 1113 males and females included in the study, whereas 7.0% of males and 4.0% of females had elastographic evidence of significant liver fibrosis. After adjustment for age, race-Hispanic origin, diabetes, cigarette smoke and BMI, a higher A/G ratio was associated with increased odds of steatosis in both males (odds ratio (OR) 1.79, 95% CI 1.07,2.99, p=0.029) and females (OR 1.95, 95% CI 1.11,3.41, p=0.023). Conversely, a significant association between A/G ratio and liver fibrosis was identified in females (OR 2.09, 95% CI 1.11,3.97, p=0.026), but not in males (OR 0.56, 95% CI 0.29,1.08, p=0.078). CONCLUSION: Independently from BMI, an android fat deposition pattern is associated with increased prevalence of NAFLD in both sexes, while the effect on fibrosis was only evident in females. |
