Open Access
Liver fat content and body fat distribution in youths with excess adiposity
(MDPI, 2018) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; Correa Rodríguez, María; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; González Ruiz, Katherine; Ciencias de la Salud; Osasun Zientziak
This study had two main objectives: To examine the association between body fat distribution and non-alcoholic fatty liver disease (NAFLD) and liver fat content, and to determine whether the relationship between NAFLD and regional body fat distribution, with respect to liver fat content in youths with excess adiposity, is independent of cardiorespiratory fitness (CRF) and a healthy diet. Liver fat content (controlled attenuation parameter (CAP)), body fat distribution (body mass index (BMI) z-score, waist circumference, waist-to-height ratio, fat mass/height, body fat percentage, total fat mass, android-to-gynoid fat mass ratio, visceral adipose tissue (VAT), and lean mass index, determined by dual-energy X-ray absorptiometry (DXA)), CRF (20-m shuttle-run test), and healthy diet (adherence to the Mediterranean diet by KIDMED questionnaire) were measured in 126 adolescents (66% girls) aged between 11 and 17 years. Participants were assigned to two groups according to the presence or absence of hepatic steatosis (CAP values >225 dB/m or <225 dB/m of liver fat, respectively). Considering the similar total fat values for the two groups (>30% by DXA), youths with NAFLD had higher fat distribution parameters than those without NAFLD, regardless of sex, age, puberty stage, lean mass index, CRF, and healthy diet (p < 0.01). In the non-NAFLD group, the association between hepatic fat and fat distribution parameters presented a similar pattern, although the association was statistically insignificant after adjusting for a potential confounding variable (ps > 0.05), except for the case of VAT. Body fat distribution parameters were higher in youths with NAFLD compared to those without NAFLD. Additionally, body fat distribution showed a significant association with liver fat content as assessed by CAP in youths with NAFLD independent of CRF and adherence to the Mediterranean diet, supporting the notion that upper body fat distribution might play a pivotal role in the development of NAFLD in adolescents. These results may have implications for the clinical management of youths with excess adiposity given the high prevalence of NAFLD in children and young adults.
Open Access
The dietary inflammatory index and hepatic health in the US adult population
(The British Dietetic Association Ltd, 2021) Ramírez Vélez, Robinson; García Hermoso, Antonio; Izquierdo Redín, Mikel; Correa Rodríguez, María; Ciencias de la Salud; Osasun Zientziak
Background: There is limited evidence on the role of an anti‐/pro‐inflammatory diet in the prevention of non‐alcoholic fatty liver disease (NAFLD). We aimed (i) to assess the anti‐inflammatory diet profile and its association with transient elastography parameters, including liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), and (ii) to analyse the relationship between the anti‐inflammatory diet and surrogate markers of liver disease in a multiethnic US population. Methods: A cross‐sectional study was conducted on a nationally representative population of 4189 US adults aged 20–80 years. A FibroScan® 502 V2 device (Echosens) was used to estimate the CAP and LSM. Liver markers, including the aspartate transaminase (AST) to alanine transaminase (ALT) ratio, fatty liver index (FLI) and fibrosis‐4 score, were also calculated. The Dietary Inflammatory Index (DII) was calculated using a 24‐h diet recall. Results: Lower DII scores (anti‐inflammatory diet) were associated with a lower AST:ALT ratio (p < 0.001) and FLI (p < 0.036) after adjusting for covariates. Linear regression analysis revealed that gamma‐glutamyl transferase levels (β = 1.702, 95% confidence interval [CI] = 0.325–3.080, p = 0.015), ALT levels (β = −0.616, 95% CI = −1.097 to −0.135, p = 0.012), AST:ALT ratio (β = 0.025, 95% CI = 0.014–0.036, p < 0.001) and FLI (β = 1.168, 95% CI = 0.224–2.112, p = 0.015) were significantly associated with the DII in the multivariable‐adjusted model. Participants in the highest anti‐inflammatory tertile had the lowest odds ratio (OR) for NAFLD assessed by FLI in both unadjusted (OR = 0.652, 95% CI = 0.539–0.788, p ≤ 0.001) and adjusted models (OR = 0.722, 95% CI = 0.537–0.972, p = 0.032). For the transient elastography parameters (LSM and CAP), no significant associations were identified. Conclusions: There was no relationship between the transient elastography parameters and the anti‐inflammatory diet profile, although our study showed an association between higher pro‐inflammatory properties of diet and poorer hepatic health assessed by surrogate markers of liver disease. Therefore, strategies to promote an anti‐inflammatory diet should be considered to prevent NAFLD in adults.

Ramírez Vélez, Robinson

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