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Comparison of Computed Tomography-based Abdominal Adiposity Indexes as Predictors of Non-alcoholic Fatty Liver Disease Among Middle-aged Korean Men and Women

 Jongmin Baek  ;  Sun Jae Jung  ;  Jee-Seon Shim  ;  Yong Woo Jeon  ;  Eunsun Seo  ;  Hyeon Chang Kim 
 Journal of Preventive Medicine and Public Health, Vol.53(4) : 256-265, 2020-07 
Journal Title
 Journal of Preventive Medicine and Public Health 
Issue Date
Abdominal fat ; Visceral-to-subcutaneous fat ratio ; Intra-abdominal fat ; Subcutaneous fat ; Fatty liver ; Non-alcoholic fatty liver disease
Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions: Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Shim, Jee Seon(심지선) ORCID logo https://orcid.org/0000-0002-8671-3153
Jeon, Yongwoo(전용우) ORCID logo https://orcid.org/0000-0002-0659-4159
Jung, Sun Jae(정선재) ORCID logo https://orcid.org/0000-0002-5194-7339
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