Korean J Radiol.  2018 Oct;19(5):923-929. 10.3348/kjr.2018.19.5.923.

Correlation between Non-Alcoholic Fatty Liver Disease and Visceral Adipose Tissue in Non-Obese Chinese Adults: A CT Evaluation

• Yu AH
• Duan-Mu YY
• Zhang Y
• Wang L
• Guo Z
• Yu YQ
• Wang YS
• Cheng XG

• KMID: 2418556
• DOI: http://doi.org/10.3348/kjr.2018.19.5.923

Abstract

OBJECTIVE
To investigate the correlation between non-alcoholic fatty liver disease and visceral adipose tissue in non-obese Chinese adults using computed tomography (CT).
MATERIALS AND METHODS
The study included 454 subjects undergoing abdominal CT scan. Degree of CT attenuation in liver and spleen, and the degree of fat infiltration in liver were evaluated according to three indices: the attenuation value of liver parenchyma (CTLP), the attenuation ratio of liver and spleen (LSratio) and the attenuation difference between liver and spleen (LSdif). Visceral fat area (VFA) and total fat area (TFA) at L2/3 and L4/5 levels were measured, and the abdominal subcutaneous fat area (SFA) was calculated. Bivariate correlation analysis was carried out to determine the correlation among these factors.
RESULTS
In men, VFA, SFA and TFA at L2/3 and L4/5 levels showed significant differences in terms of the three indices to distinguish fatty liver from non-fatty liver (all, p < 0.001). In men, all the three indices showed negative correlation with TFA, SFA and VFA (all, p < 0.001). The negative correlation between the three indices and VFA at the L2/3 level was higher than at L4/5 level (r = −0.476 vs. r = −0.340 for CTLP, r = −0.502 vs. r = −0.413 for LSratio, r = −0.543 vs. r = −0.422 for LSdif, p < 0.001, respectively). The negative correlation between LSratio, LSdif and VFA at L2/3 and L4/5 levels was higher than SFA at the corresponding level. In women, all the three indices showed negative correlation with VFA and TFA at L2/3 and L4/5 levels, and the negative correlation between CTLP and VFA was higher at L2/3 level than at L4/5 level (r = −0.294 vs. r = −0.254, p < 0.001).
CONCLUSION
In non-obese Chinese adults, the degree of hepatic fatty infiltration showed a strong correlation with abdominal fat on CT. VFA at L2/3 level was more closely related to fatty liver compared with VFA at L4/5 level.

Keyword

Fatty liver; NASH; Visceral fat; Computed tomography; CT Quantification; Quantitative diagnosis

MeSH Terms

Abdominal Fat
Adult*
Asian Continental Ancestry Group*
Fatty Liver
Female
Humans
Intra-Abdominal Fat*
Liver
Male
Non-alcoholic Fatty Liver Disease*
Spleen
Subcutaneous Fat, Abdominal
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Attenuation measurements of liver and spleen.Three regions of interest in liver and 2 regions of interest in spleen at level of hepatic portal vein were selected (avoiding blood vessels, bile ducts and calcification).

• 

  Fig. 2 CT measurement of abdominal fat.Sagittal and coronal CT images showed that L2/3 and L4/5 were horizontal levels of L2 and L4 vertebral body lower edges, respectively. Cross-sectional image showed that blue region represented adipose tissues, yellow region denoted muscles and soft tissues, and green region indicated vertebral bodies and accessories; outside green dots suggested subcutaneous fat, and inside green dots pointed to visceral fat. SFA = subcutaneous fat area, VFA = visceral fat area

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