Obesity has recently become a critical problem in patients with cirrhosis in Japan; however, its true prevalence and prognosis remain poorly understood. In this study, we investigated abdominal fat areas, including subcutaneous and visceral fat areas (VFA), in 49 cirrhotic patients and analyzed the association between VFA and body mass index (BMI). Fat areas were examined by computed tomography. Patients were classified as somatometric obesity and visceral obesity based on their BMI (cut-off value: 25 kg/m2) and VFA (cut-off value: 100 cm2), respectively. The mean BMI was 23.5±3.3 kg/m2 (<25 kg/m2, 35 cases; 25 kg/m2, 14 cases) and mean VFA was 108.5±118.8 cm2 (<100 cm2, 25 cases; 100 cm2, 24 cases). Thirteen out of 14 patients with BMI 25 kg/m2 had a VFA 100 cm2, and 11 of 35 patients with BMI <25 kg/m2 had a VFA 100 cm2. Thus, almost half of the cirrhotic patients in this study had visceral obesity, including a high proportion of patients with BMI <25 kg/m2. These results suggest that visceral obesity, as well as BMI, should be considered in patients with cirrhosis, and individual nutritive management regimes should be designed according to the results.
McLaren L. Socioeconomic status and obesity. Epidemiol Rev 2007; 29: 29-48. http://dx.doi.org/10.1093/epirev/mxm001
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625-38. http://dx.doi.org/10.1056/NEJMoa021423
Muto Y, Sato S, Watanabe A, Moriwaki H, Suzuki K, Kato A, et al. Effects of oral branched-chain amino acid granules on event-free survival in patients with liver cirrhosis. Clin Gastroenterol Hepatol 2005; 3: 705-13. http://dx.doi.org/10.1016/S1542-3565(05)00017-0
Tajika M, Kato M, Mohri H, Miwa Y, Kato T, Ohnishi H, Moriwaki H. Prognostic value of energy metabolism in patients with viral liver cirrhosis. Nutrition 2002; 18: 229-34. http://dx.doi.org/10.1016/S0899-9007(01)00754-7
Shiraki M, Nishiguchi S, Saito M, Fukuzawa Y, Mizuta T, Kaibori M, et al. Nutritional status and quality of life in current patients with liver cirrhosis as assessed in 2007-2011. Hepatol Res 2013; 43: 106-12. http://dx.doi.org/10.1111/hepr.12004
Campillo B, Bories PN, Leluan M, Pornin B, Devanlay M, Fouet P. Short-term changes in energy metabolism after 1 month of a regular oral diet in severely malnourished cirrhotic patients. Metabolism 1995; 44: 765-70. http://dx.doi.org/10.1016/0026-0495(95)90190-6
Yasutake K, Bekki M, Ichinose M, Ikemoto M, Fujino T, Ryu T, et al. Assessing current nutritional status of patients with HCV-related liver cirrhosis in the compensated stage. Asia Pac J Clin Nutr 2012; 21: 400-5.
Yoshizumi T, Nakamura T, Yamane M, Islam AH, Menju M, Yamasaki K, et al. Abdominal fat: standardized technique for measurement at CT. Radiology 1999; 211: 283-6. http://dx.doi.org/10.1148/radiology.211.1.r99ap15283
Hiuge-Shimizu A, Kishida K, Funahashi T, Ishizaka Y, Oka R, Okada M, et al. Absolute value of visceral fat area measured on computed tomography scans and obesity-related cardiovascular risk factors in large-scale Japanese general population (the VACATION-J study). Ann Med 2012; 44: 82-92. http://dx.doi.org/10.3109/07853890.2010.526138
Oka R, Miura K, Sakurai M, Nakamura K, Yagi K, Miyamoto S, et al. Comparison of waist circumference with body mass index for predicting abdominal adipose tissue. Diabetes Res Clin Pract 2009; 83: 100-5. http://dx.doi.org/10.1016/j.diabres.2008.10.001
Vega GL, Adams-Huet B, Peshock R, Willett D, Shah B, Grundy SM. Influence of body fat content and distribution on variation in metabolic risk. J Clin Endocrinol Metab 2006; 91: 4459-66. http://dx.doi.org/10.1210/jc.2006-0814
Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116: 39-48. http://dx.doi.org/10.1161/CIRCULATIONAHA.106.675355
Nakamura T, Matsuzawa Y. Life style-related diseases and fat cells. Nihon Naika Gakkai Zasshi 2001; 90: 1753-8. http://dx.doi.org/10.2169/naika.90.1753
Imano E, Kanda T, Nakatani Y, Motomura M, Arai K, Matsuhisa M, et al. Impaired splanchnic and peripheral glucose uptake in liver cirrhosis. J Hepatol 1999; 31: 469-73. http://dx.doi.org/10.1016/S0168-8278(99)80039-7
Ida M, Hirata M, Odori S, Mori E, Kondo E, Fujikura J, et al. Early changes of abdominal adiposity detected with weekly dual bioelectrical impedance analysis during calorie restriction. Obesity 2013; 21: E350-3.
Ida M, Hirata M, Hosoda K, Nakao K. Abdomen specific bioelectrical impedance analysis (BIA) methods for evaluation of abdominal fat distribution. Nihon Rinsho 2013; 71: 262-5.
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Copyright (c) 2014 Kenichiro Yasutake, Motoyuki Kohjima, Yusuke Murata, Manabu Nakashima, Makoto Nakamuta , Munechika Enjoji