Journal of Basic Research in Medical Sciences
J Basic Res Med Sci
Volume 13, Issue 3 (6-2026)
jbrms 2026, 13(3): 38-47 |
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Zeynizadeh Jeddi S, Sharghi A, Ghorbani Davatgar S. The Relationship of Thickness of the Subcutaneous Fat of the Anterior Abdominal Wall and the grade of Hepatic Steatosis. jbrms 2026; 13 (3) :38-47
URL: http://jbrms.medilam.ac.ir/article-1-968-en.html
URL: http://jbrms.medilam.ac.ir/article-1-968-en.html
Department of Radiology, School of medicine, Ardabil university of medical science, Ardabil, Iran. , s.zeynizadeh@arums.ac.ir
Abstract: (241 Views)
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of fat buildup in the liver, which results in liver disease. This condition is becoming more commonplace worldwide. Knowing the causes of the disease is crucial for preventing and minimizing its effects, especially since the etiology of the condition is not fully understood. The aim of this study was to investigate the relationship between hepatic steatosis grading and the thickness of the subcutaneous fat of the anterior abdominal wall.
Materials & Methods: In this descriptive cross-sectional study, all 181 patients underwent ultrasound scanning to determine the grade of their fatty liver, as well as to measure the thickness of the anterior abdominal wall's subcutaneous fat at the RUQ. The fatty liver grading was between 0 and 3. The questionnaire was filled out with the patient's height, weight, age, gender, fatty liver grade, thickness of subcutaneous fat, and underlying medical conditions.
Results: This study revealed that the distribution of hepatic steatosis among 47% of participants was normal (grade 0), while 42.5%, 9.4%, and 1.1% were classified as grade 1, grade 2, and grade 3 of fatty liver, respectively, as per ultrasonographic classification. Quantitative analysis of abdominal adiposity showed a mean anterior abdominal wall subcutaneous fat thickness of 16.31±6.45 mm. Crucially, subcutaneous fat thickness showed a significant positive correlation with hepatic steatosis grade (r = 0.39, p = 0.001), and each additional millimeter of fat thickness raised the likelihood of advanced steatosis. These results substantiate the clinical relevance of abdominal wall fat measurement as a potential surrogate marker for NAFLD severity.
Conclusion: The current study showed that more than half of patients had fatty liver in grades 1-3, and programming to change the lifestyle of people to avoid weight gain and manage NAFLD is necessary
Materials & Methods: In this descriptive cross-sectional study, all 181 patients underwent ultrasound scanning to determine the grade of their fatty liver, as well as to measure the thickness of the anterior abdominal wall's subcutaneous fat at the RUQ. The fatty liver grading was between 0 and 3. The questionnaire was filled out with the patient's height, weight, age, gender, fatty liver grade, thickness of subcutaneous fat, and underlying medical conditions.
Results: This study revealed that the distribution of hepatic steatosis among 47% of participants was normal (grade 0), while 42.5%, 9.4%, and 1.1% were classified as grade 1, grade 2, and grade 3 of fatty liver, respectively, as per ultrasonographic classification. Quantitative analysis of abdominal adiposity showed a mean anterior abdominal wall subcutaneous fat thickness of 16.31±6.45 mm. Crucially, subcutaneous fat thickness showed a significant positive correlation with hepatic steatosis grade (r = 0.39, p = 0.001), and each additional millimeter of fat thickness raised the likelihood of advanced steatosis. These results substantiate the clinical relevance of abdominal wall fat measurement as a potential surrogate marker for NAFLD severity.
Conclusion: The current study showed that more than half of patients had fatty liver in grades 1-3, and programming to change the lifestyle of people to avoid weight gain and manage NAFLD is necessary
Type of Study: Research |
Subject:
Internal medicine
Received: 2025/04/30 | Accepted: 2025/11/4 | Published: 2026/06/16
Received: 2025/04/30 | Accepted: 2025/11/4 | Published: 2026/06/16
References
1. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84.https://doi.org/ 10.1002/hep.28431. [DOI:10.1002/hep.28431.]
2. Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet. 2021;397(10290):2212-2224. [DOI:10.1016/S0140-6736(20)32511-3.]
3. Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA. 2015;313(22):2263-73. [DOI:10.1001/jama.2015.5370]
4. Allen AM, Van Houten HK, Sangaralingham LR, Talwalkar JA, McCoy RG. Healthcare Cost and Utilization in Nonalcoholic Fatty Liver Disease: Real-World Data From a Large U.S. Claims Database. Hepatology. 2018;68(6):2230-38. [DOI:10.1002/hep.30094.]
5. Ilyas F, Ali H, Patel P, Sarfraz S, Basuli D, Giammarino A, et al. Increasing nonalcoholic fatty liver disease-related mortality rates in the United States from 1999 to 2022. Hepatol Commun. 2023;7(7):e00207. [DOI:10.1097/HC9.0000000000000207.]
6. Friedman SL. Mechanisms of NAFLD development. Nat Med.2018;24(7):908-22. https://doi.org/ 10.1038/s41591-018-0104-9. [DOI:10.1038/s41591-018-0104-9.]
7. Mantovani A, Byrne CD, Bonora E, Targher G. Nonalcoholic Fatty Liver Disease and Risk of Incident Type 2 Diabetes: A Meta-analysis. Diabetes Care. 2018;41(2):372-82. [DOI:10.2337/dc17-1902.]
8. Hernaez R, Lazo M, Bonekamp S, Kamel I, Brancati FL, Guallar E, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-90. [DOI:10.1002/hep.24452.]
9. Mustapic S, Ziga S, Matic V, Bokun T, Radic B, Lucijanic M, Marusic S, Babic Z, Grgurevic I. Ultrasound Grade of Liver Steatosis Is Independently Associated with the Risk of Metabolic Syndrome. Can J Gastroenterol Hepatol. 2018;2018:8490242. [DOI:10.1155/2018/8490242.]
10. Okanoue T, Umemura A, Yasui K, Itoh Y. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in Japan. J gastroenterolo hepatol.2011;26:153-62. [DOI:10.1111/j.1440-1746.2010.06547.x.]
11. Kagansky N, Levy Sh, Keter D, Rimon E, Taiba Z,Fridman Z, et al. Non-alcoholic fatty liver disease–a common and benign finding in octogenarian patients. Liver Int. 2004;24(6):588-94. [DOI:10.1111/j.1478-3231.2004.0969.x.]
12. Sweeny KF, Lee CK. Nonalcoholic Fatty Liver Disease in Children. Gastroenterol Hepatol (N Y). 2021;17(12):579-587.
13. Hashimoto E, Tokushige K. Prevalence, gender, ethnic variations, and prognosis of NASH. Journal of gastroenterology. 2011;46:63-69. [DOI:10.1007/s00535-010-0311-8.]
14. FAN JG, Zhu J, Li XJ, Chen L, Lu YS, Li L, et al. Fatty liver and the metabolic syndrome among Shanghai adults.J gastroenterol hepatol.2005;20(12):1825-32. https://doi.org/ 10.1111/j.1440-1746.2005.04058.x. [DOI:10.1111/j.1440-1746.2005.04058.x.]
15. Fan JG, Farrell GC. Epidemiology of non-alcoholic fatty liver disease in China. Journal of hepatology. 2009;50(1):204-210. [DOI:10.1016/j.jhep.2008.10.010.]
16. Chiang DJ, Pritchard MT, Nagy LE. Obesity, diabetes mellitus, and liver fibrosis. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2011;300(5):G697-G702. [DOI:10.1152/ajpgi.00426.2010.]
17. Larson-Meyer DE, Heilbronn LK, Redman LM, Newcomer BR, Frisard MI, Anton S, et al. Effect of calorie restriction with or without exercise on insulin sensitivity, β-cell function, fat cell size, and ectopic lipid in overweight subjects. Diabetes care. 2006;29(6):1337-44. [DOI:10.2337/dc05-2565.]
18. Stewart KJ, Bacher AC, Turner K, Lim JG,Hees PS, Shapiro EP, et al. Exercise and risk factors associated with metabolic syndrome in older adults. Am J Prev Med. 2005;28(1):9-18. [DOI:10.1016/j.amepre.2004.09.006.]
19. Rafiq N, Younossi ZM. Effects of weight loss on nonalcoholic fatty liver disease. Semin Liver Dis.2008;28(4)::427-33. https://doi.org/ 10.1055/s-0028-1091986. [DOI:10.1055/s-0028-1091986.]
20. Ueno T, Sugawara H, Sujaku K, et al. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. Journal of hepatology.1997;27(1):103-107. https://doi.org/ 10.1016/s0168-8278(97)80287-5. [DOI:10.1016/s0168-8278(97)80287-5.]
21. Shah K, Stufflebam A, Hilton TN, Sinacore DR, Klein S, Villareal DT. Diet and exercise interventions reduce intrahepatic fat content and improve insulin sensitivity in obese older adults. Obesity. 2009;17(12):2162-2168. [DOI:10.1038/oby.2009.126.]
22. Marchesini G, Bugianesi E, Forlani G, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003;37(4):917-23. [DOI:10.1053/jhep.2003.50161.]
23. Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. New England Journal of Medicine. 2010;363(14):1341-50. [DOI:10.1056/NEJMra0912063.]
24. Liu H, Lu H-Y. Nonalcoholic fatty liver disease and cardiovascular disease. World journal of gastroenterology: WJG. 2014;20(26):8407. [DOI:10.3748/wjg.v20.i26.8407.]
25. Perseghin G, Lattuada G, De Cobelli F, et al. Increased mediastinal fat and impaired left ventricular energy metabolism in young men with newly found fatty liver. Hepatology. 2008;47(1):51-8. [DOI:10.1002/hep.21983.]
26. Okamoto M, Takeda Y, Yoda Y, Kobayashi K, Fujino MA, Yamagata Z. The association of fatty liver and diabetes risk. Journal of epidemiology. 2003;13(1):15-21. [DOI:10.2188/jea.13.15.]
27. Yamazaki H, Tsuboya T, Tsuji K, Dohke M, Maguchi H. Independent association between improvement of nonalcoholic fatty liver disease and reduced incidence of type 2 diabetes. Diabetes care. 2015;38(9):1673-79. [DOI:10.2337/dc15-0140.]
28. Salehi M, Islamivaghar M, Nasrabadi T. Evaluation of the relationship between fatty liver disease and diabetes in patients referred to hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. Journal of Diabetes Nursing. 2016;4(2):25-39.
29. Yamada T, Fukatsu M, Suzuki S, Wada T, Yoshida T, Joh T. Fatty liver predicts impaired fasting glucose and type 2 diabetes mellitus in Japanese undergoing a health checkup. Journal of gastroenterology and hepatology. 2010;25(2):352-6. [DOI:10.1111/j.1440-1746.2009.05998.x.]
30. Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140(1):124-31. https://doi.org/ 10.1053/j.gastro.2010.09.038. [DOI:10.1053/j.gastro.2010.09.038.]
31. Tohidi M, Harati H, Hadaege F, Mehrabi Y, Azizi F. Association of liver enzymes with incident type 2 diabetes: Tehran lipid and glucose study. Journal of Diabetes and Metabolic Disorders. 2007; 7:5-8.
32. Schmitz-Peiffer C. Signalling aspects of insulin resistance in skeletal muscle: mechanisms induced by lipid oversupply. Cellular signalling. 2000;12(9):583-94. [DOI:10.1016/s0898-6568(00)00110-8.]
33. Lazo M, Clark JM. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis.2008;28(4):339-50. [DOI:10.1055/s-0028-1091978.]
34. Liu CC, Hung CL, Shih SC, Ko HJ, Lu YT, Wu YJ, et al. Age-related Differences in the Clinical Presentation, Associated Metabolic Abnormality, and Estimated Cardiovascular Risks from Nonalcoholic Fatty Liver Disease: A Cross-sectional Study from Health Evaluation Center in Taiwan. International Journal of Gerontology.2010;4(4):184-91. [DOI:10.1016/j.ijge.2010.11.005]
35. Fukuda K, Seki Y, Ichihi M, Okada T, Hirata A, Kogita S, et al. Usefulness of ultrasonographic estimation of preperitoneal and subcutaneous fat thickness in the diagnosis of nonalcoholic fatty liver disease in diabetic patients. Journal of Medical Ultrasonics. 2015;42:357-63. [DOI:10.1007/s10396-015-0615-7.]
36. Liu K, Chan Y, Chan J, Chan W, Kong W. Mesenteric fat thickness as an independent determinant of fatty liver. International journal of obesity.2006;30(5):787-93. [DOI:10.1038/sj.ijo.0803201.]
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