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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 101

The importance of visceral adipose tissue detected by imaging methods to assess nonalcoholic fatty liver disease properly


1 Department of Biochemistry, Gata Haydarpasa Training Hospital, Istanbul, Turkey
2 Department of Cardiology, Gata Haydarpasa Training Hospital, Istanbul, Turkey

Date of Submission01-Jun-2016
Date of Acceptance03-Feb-2017
Date of Web Publication24-Aug-2021

Correspondence Address:
Fatih Ozcelik
Department of Biochemistry, GATA Haydarpasa Training Hospital, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpvm.IJPVM_203_16

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How to cite this article:
Ozcelik F, Ozmen N. The importance of visceral adipose tissue detected by imaging methods to assess nonalcoholic fatty liver disease properly. Int J Prev Med 2021;12:101

How to cite this URL:
Ozcelik F, Ozmen N. The importance of visceral adipose tissue detected by imaging methods to assess nonalcoholic fatty liver disease properly. Int J Prev Med [serial online] 2021 [cited 2021 Dec 5];12:101. Available from: https://www.ijpvmjournal.net/text.asp?2021/12/1/101/324548



Dear Editor,

We read the article entitled “The Effect of Symbiotic Supplementation on Liver Enzymes, C-reactive protein (CRP), and ultrasound findings in patients with nonalcoholic fatty liver disease (NAFLD): A Clinical Trial” with great interest.[1] In this study, authors reported that symbiotic supplementation improved the grade of hepatosteatosis in NAFLD patients without any change in alanine aminotransferase, aspartate aminotransferase, and CRP levels. With this aspect, the current study offers a new perspective on the management of NAFLD. However, there is a lack of information about the association between amount of visceral adipose tissue (VAT) which is an important factor for fat accumulation in liver, presence of diabetes, metabolic syndrome (MetS), hyperlipidemia, and NAFLD. Therefore, we would like to make some important contributions in this regard.

It is believed that insulin resistance (IR) and impaired thyroid hormone action, which may cause decreased mitochondrial oxidative capacity and make changes in gene expression regarding RNA, protein, and energy metabolism, play a key role in fat accumulation in the liver.[2],[3] In our previous study associated with this issue, (a) fibrinogen and CRP levels were found to be significantly higher in patients with the homeostasis model assessment-IR (HOMA-IR) ≥4 and Grade 3 hepatosteatosis, which was described as severe pathology group, (b) there was a weak positive correlation between grade of hepatosteatosis and insulin level and a moderate positive correlation between grade of hepatosteatosis and IR, (c) adiponectin levels were higher in patients in mild pathology group (HOMA-IR ≥2.5 and Grade 0 hepatosteatosis or HOMA-IR <2.5 and Grade 1–2 hepatosteatosis) compared to the other severe two groups, and (d) VAT calculated with a single axial tomographic profile taken from the umbilical level, HBA1c, glucose, HOMA-IR, and insulin levels was increased in parallel with the increase in pathological stages.[4] In parallel with our study, some researchers reported that VAT has a higher lipolytic activity, which increases the amount of free fatty acids transferred to liver and leads to hyperinsulinemia caused the development of NAFLD. In recent studies, IR, MetS, and liver fat content were found to be more strongly related with the amount of VAT compared to the other obesity indicators such as body mass index and circumference waist.[2],[5]

In light of these informations mentioned above, considering important risk factors such as VAT that may possibly be associated with hepatosteatosis besides grading liver steatosis will allow us to make a better assessment in studies performed to manage and prevent NAFLD. In addition, more information about the mechanisms affecting these results will be obtained.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Asgharian A, Askari G, Esmailzade A, Feizi A, Mohammadi V. The effect of symbiotic supplementation on liver enzymes, C-reactive protein and ultrasound findings in patients with non-alcoholic fatty liver disease: A Clinical trial. Int J Prev Med 2016;7:59.  Back to cited text no. 1
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2.
Lomonaco R, Ortiz-Lopez C, Orsak B, Webb A, Hardies J, Darland C, et al. Effect of adipose tissue insulin resistance on metabolic parameters and liver histology in obese patients with nonalcoholic fatty liver disease. Hepatology 2012;55:1389-97.  Back to cited text no. 2
    
3.
Pihlajamäki J, Boes T, Kim EY, Dearie F, Kim BW, Schroeder J, et al. Thyroid hormone-related regulation of gene expression in human fatty liver. J Clin Endocrinol Metab 2009;94:3521-9.  Back to cited text no. 3
    
4.
Ozcelik F, Yuksel C, Arslan E, Genc S, Omer B, Serdar MA, et al. Relationship between visceral adipose tissue and adiponectin, inflammatory markers and thyroid hormones in obese males with hepatosteatosis and insulin resistance. Arch Med Res 2013;44:273-80.  Back to cited text no. 4
    
5.
Wajchenberg BL. Subcutaneous and visceral adipose tissue: Their relation to the metabolic syndrome. Endocr Rev 2000;21:697-738.  Back to cited text no. 5
    




 

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