Identification of Hepatic Steatosis in Premenopausal and Postmenopausal Women Based on Phenotypes Combining Triglyceride Levels and Anthropometric Indices: A Cross-Sectional Study
Authors Liu PJ, Lou HP, Zhu YN
Received 16 January 2021
Accepted for publication 11 March 2021
Published 23 March 2021 Volume 2021:14 Pages 1339—1347
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Antonio Brunetti
Peng Ju Liu,1 Hui Ping Lou,2 Yan Ning Zhu3
1Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China; 2Medical Examination Center, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
Correspondence: Peng Ju Liu
Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, #1 Shuaifuyuan, Dongcheng District, Beijing, 100730, People’s Republic of China
Tel +86 10-69155550
Fax +86 10-69155551
Email [email protected]
Background: The hypertriglyceridemic waist phenotype (HWP) has exhibited a strong association with metabolic syndrome, a condition closely linked with nonalcoholic fatty liver disease (NAFLD). However, no study has investigated whether the HWP can accurately predict NAFLD among premenopausal and postmenopausal women or whether alternative anthropometric indexes could replace waist circumference (WC) in the HWP. We examined the power of phenotypes combining triglyceride (TG) levels with anthropometric indexes such as body mass index (BMI), WC, waist-to-hip ratio, waist-to-height ratio, and percent body fat, to detect NAFLD among premenopausal and postmenopausal women.
Methods: We conducted a cross-sectional study of 1125 premenopausal women and 654 postmenopausal women who had received an annual health checkup. For all the participating women, we measured both anthropometric and biochemical indexes, such as serum lipid levels. NAFLD diagnoses were made on the basis of abdominal ultrasonography findings. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the indicators’ ability to detect NAFLD.
Results: Among the indicators of hepatic steatosis, the combined phenotypes of TG level (≥ 1.50 mmol/L) and BMI (≥ 24.0 kg/m2) exhibited the largest AUC (0.841, 95%confidence interval [CI] 0.812– 0.871, P< 0.001) for premenopausal women, whereas WC alone exhibited the highest predictive potential (0.765, 95% CI 0.729– 0.801, P< 0.001) for postmenopausal women.
Conclusion: Out of all the phenotypes combining a single anthropometric index with TG level or WC and TG level, the combination of TG level and BMI was the best indicator of NAFLD for premenopausal women. For screening NAFLD in postmenopausal women, WC alone was superior to all other indicators.
Keywords: nonalcoholic fatty liver disease, hepatic steatosis, anthropometric index, hypertriglyceridemic waist phenotype, menopause
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