Waist circumference as a predictor for severity of liver fibrosis in non-alcoholic fatty liver disease patients.

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) may in some cases progress to increasing grades of liver fibrosis and eventually cirrhosis. NAFLD patients often succumb to cardiovascular causes. Previous studies have linked visceral fat, a known cardiovascular risk factor, to NAFLD. Visceral fat is best quantified by measuring the waist circumference (WC). This study is aimed to determine the association of waist circumference with severity of liver fibrosis in NAFLD patients.

Methods: In this cross-sectional study we recruited 82 NAFLD patients diagnosed via ultrasonography. They underwent anthropometric examination followed by transient elastography with Fibro Scan to assess of liver stiffness measure (LSM). A cutoff LSM value of 7kPa was used to indicate significant fibrosis. Among the participants, 40 patients had an LSM value of <7 kPa (insignificant/no fibrosis), while 42 were found to have >7 kPa (significant fibrosis). Biochemical parameters of Lipid profile and Liver enzymes were also analyzed.

Statistical analysis used: SPSS software with Student t-test, Chi-square t-test, ANOVA, and Spearman correlation with 95% CI is used. P <0.05 is considered significant.

Results: Patients with significant fibrosis had higher mean weight (P < 0.001), BMI (P = 0.009), WC (P = 0.002), and waist-hip ratio (WHR, P = 0.032) compared to those with no fibrosis. However, hip circumference (HC) was not significantly associated between the two groups. In correlation studies, BMI (P = 0.001), weight (P < 0.001), WC (P = 0.001), and HC (P = 0.008) positively correlated with severity of liver fibrosis in NAFLD patients. However, no significant correlation was found with WHR.

Conclusion: Weight, BMI, and visceral fat indicators like WC and WHR are strongly associated with liver fibrosis severity in NAFLD patients. Notably, weight, BMI, WC, and HC positively correlate with fibrosis severity, while WHR does not. Early diagnosis of fatty liver is crucial to prevent progression to life-threatening conditions like NASH or NASH cirrhosis. Waist circumference could serve as a practical screening tool in primary health care centres for identifying NAFLD patients at risk of fibrosis progression.