Abstract
Background
Adults with a healthy Body Mass Index but elevated body fat are at risk for a variety of undetected metabolic problems. It is unclear whether non-alcoholic fatty liver is associated with this body type.
Participants/Methods
Associations between elevated body fat and non-alcoholic fatty liver disease (NAFLD) among adults with a healthy Body Mass Index (18.5–24.9) were assessed. A cohort of healthy BMI, non-pregnant, adults without history of liver disease or recent heavy drinking was constructed from the NHANES 2017–2018 survey. Body fat percentages were determined from whole-body DXA scans. Liver ultrasound transient elastography indicated the presence of hepatic steatosis.
Results
A significantly larger proportion of adults with an elevated body fat % (46.2%) than those with a healthy body fat % (25.1%) (p = 0.002) had undiagnosed NAFLD. In a logistic regression adjusted for age, sex, race/ethnicity, and exercise, hepatic steatosis was associated with an elevated body fat percentage within the cohort of adults with a healthy BMI (OR 3.51; 95% CI 2.11–5.86).
Conclusion
The usefulness of alternative body composition measures should be considered when screening for NAFLD.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Data availability
The NHANES is a publicly accessible de-identified dataset. All of the data used in this study can be found at https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2017.
References
Grover SA, Kaouache M, Rempel P, Joseph L, Dawes M, Lau DC, et al. Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study. Lancet Diabetes Endocrinol. 2015;3:114–22.
Milić S, Lulić D, Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations. World J Gastroenterol. 2014;20:9330–7.
Mainous AG 3rd, Tanner RJ, Jo A, Anton SD. Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend. Ann Fam Med. 2016;14:304–10.
Wee CC, Hamel MB, Huang A, Davis RB, Mittleman MA, McCarthy EP. Obesity and undiagnosed diabetes in the U.S. Diabetes Care. 2008;31:1813–5. https://doi.org/10.2337/dc07-1867.
Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014;56:426–33.
Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011;9:524–e1. Junquiz e60
Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol. 2019;71:793–801.
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. Int J Epidemiol. 2014;43:655–65.
Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1–452.
National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking Accessed 11 April, 2022.
Ferraioli G, Wong VW, Castera L, Berzigotti A, Sporea I, Dietrich CF, et al. Liver Ultrasound Elastography: an Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound Med Biol. 2018;44:2419–40.
da Silva LCM, de Oliveira JT, Tochetto S, de Oliveira CPMS, Sigrist R, Chammas MC. Ultrasound elastography in patients with fatty liver disease. Radiol Bras. 2020;53:47–55.
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf Accessed 11 April, 2022.
Author information
Authors and Affiliations
Contributions
AM—supervision, conceptualization, visualization, writing-original draft preparation, writing-review, and editing. BR—data curation, formal analysis, conceptualization, writing-original draft preparation, writing-review, and editing. JM—conceptualization, writing-original draft preparation, writing-review, and editing. SD—conceptualization, writing-original draft preparation, writing-review, and editing.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Mainous, A.G., Rooks, B.J., Medley, J.F. et al. Body composition among adults at a healthy body mass index and association with undetected non-alcoholic fatty liver. Int J Obes 46, 1403–1405 (2022). https://doi.org/10.1038/s41366-022-01124-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41366-022-01124-0
This article is cited by
-
Association of body fat and muscle tissue parameters with fatty liver disease identified by ultrasound
Lipids in Health and Disease (2023)