Shelley E Keating1,2, Helen M Parker1, Ingrid J Hickman3,4,5, Sjaan R Gomersall6, Matthew P Wallen2,7, Jeff S Coombes2, Graeme A Macdonald5,8,9, Jacob George10, Nathan A Johnson1,11. 1. Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia. 2. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia. 3. Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia. 4. Mater Research Institute, The University of Queensland, South Brisbane, QLD, Australia. 5. Translational Research Institute, Brisbane, QLD, Australia. 6. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia. 7. Faculty of Health, Federation University Australia, Mount Helen, VIC, Australia. 8. Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia. 9. Department of Anaesthesia, Princess Alexandra Hospital, Brisbane, QLD, Australia. 10. Storr Liver Centre, Westmead Institute for Medical Research and Westmead Hospital, University of Sydney, Westmead, NSW, Australia. 11. Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia.
Abstract
BACKGROUND & AIMS: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1 H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1 H-MRS-quantified liver fat. METHODS: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2 , liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1 H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. RESULTS: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1 H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively. CONCLUSIONS: Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
BACKGROUND & AIMS: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1 H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1 H-MRS-quantified liver fat. METHODS: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2 , liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1 H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. RESULTS: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1 H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively. CONCLUSIONS: Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
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