NAFLD in clinical practice: Can simple blood and anthropometric markers be used to detect change in liver fat measured by 1 H-MRS?

Shelley E Keating; Helen M Parker; Ingrid J Hickman; Sjaan R Gomersall; Matthew P Wallen; Jeff S Coombes; Graeme A Macdonald; Jacob George; Nathan A Johnson

doi:10.1111/liv.13488

NAFLD in clinical practice: Can simple blood and anthropometric markers be used to detect change in liver fat measured by ¹ H-MRS?

Liver Int. 2017 Dec;37(12):1907-1915. doi: 10.1111/liv.13488. Epub 2017 Jun 29.

Authors

Shelley E Keating^{1

2}, Helen M Parker¹, Ingrid J Hickman^{3

4

5}, Sjaan R Gomersall⁶, Matthew P Wallen^{2

7}, Jeff S Coombes², Graeme A Macdonald^{5

8

9}, Jacob George¹⁰, Nathan A Johnson^{1

11}

Affiliations

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.

PMID: 28581252
DOI: 10.1111/liv.13488

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.

Keywords: biomarkers; intrahepatic triglyceride; non-alcoholic fatty liver disease; visceral adiposity.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Humans
Male
Middle Aged
Non-alcoholic Fatty Liver Disease / blood
Non-alcoholic Fatty Liver Disease / diagnosis*
Proton Magnetic Resonance Spectroscopy
Severity of Illness Index
Waist Circumference