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- Waist-to-Hip Ratio is Related to Body Fat Content and Distribution Regardless of the Waist Circumference Measurement Protocol, in Non-Alcoholic Fatty Liver Disease PatientsPublication . Pimenta, Nuno; Santa-Clara, Helena; Melo, Xavier; Cortez-Pinto, Helena; Silva Nunes, José António; Sardinha, LuisCentral accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in non-alcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with Dual Energy X-ray Absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 yrs, and 9 females, 47 ± 13 yrs). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r=0.47 for WHR1; r=0.59 for WHR2 and WHR3; r=0.58 for WHR4) and BF distribution (r=0.45 for WHR1; r=0.56 for WHR2 and WHR3; r=0.51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients.
- Finding the best waist circumference measurement protocol in patients with nonalcoholic fatty liver diseasePublication . Pimenta, Nuno; Santa-Clara, Helena; Melo, Xavier; Cortez-Pinto, Helena; Silva Nunes, José António; Sardinha, LuisBackground Central fat accumulation is important in Non-alcoholic Fatty Liver Disease (NAFLD) etiology. It is unknown weather any commonly used waist circumference (WC) measurement protocol (mp), as whole and central fat accumulation marker, is preferable for patients with NAFLD. The present study sought to find a preferable WC mp to be used in patients with NAFLD, based on three-fold criterion. Material and methods Body fat (BF) was assessed through Dual Energy X-ray Absorptiometry (DXA) in 28 patients with NAFLD (19 males, 51 + 13 yrs, and 9 females, 47 + 13 yrs). WC was measured using four different WC mp (WC1-narrowest torso, WC2- just above iliac crest, WC3- mid-distance between iliac crest and last rib and WC4- at the umbilicus). Results All WC measurements were highly correlated particularly with central BF depots, including trunk BF (r=0.78; r=0.82; r=0.82; r=0.84; respectively for WC1, WC2, WC3 and WC4) abdominal BF (r=0.78; r=0.78; r=0.80; r=0.72; respectively for WC1, WC2, WC3 and WC4) and central abdominal BF (r=0.76; r=0.77; r=0.78; r=0.68; respectively for WC1, WC2, WC3 and WC4), controlling for age, sex and body mass index. There were no differences between the correlation coefficients obtained between all studied WC measurements and each whole and central analyzed BF variable. Conclusion All studied WC mp seem suitable for use in patients with NAFLD, particularly as central BF clinical assessment tool, though not interchangeably. Hence biological and precision criteria alone did not sanction the superiority of any WC mp. Practical criteria may endorse WC measured at the iliac crest.