The role of visceral fat in the formation of hepatic and cardiac changes in patients with non-alcoholic fatty liver disease and normal body weight

Вackground. Non-alcoholic fatty liver disease (NAFLD) occupies a leading place in the world among liver diseases and is accompanied by the development of steatosis and steatohepatitis, and in some cases progressing to cirrhosis and hepatocarcinoma. It is generally believed that NAFLD in most cases is associated with overweight and obesity. However, excess visceral fat is also found in patients with normal body weight (BMI).

Aim. The aim of this study was to evaluate the role of visceral obesity (VO) in the formation of hepatic and cardiac changes in patients with NAFLD and normal body weight, overweight and obesity.

Materials and methods. The study included 135 patients with cardiovascular diseases (arterial hypertension, ischemic heart disease (IHD)) and NAFLD between the ages of 45 and 65, what formed 3 groups: with normal body weight (NBW) overweight and obesity. The control group – 30 patients without a history of NAFLD, aged 50 to 63 years. All patients underwent an assessment of anthropometric parameters (height, weight, body mass index, measurement of WHR (W: H) = Waist circumference / Hip circumference, echocardiography, biochemical blood tests with determination of liver condition by calculated Fatty Liver Index (FLI) and Fibrosis‑4 index (FIB‑4), calculation of Visceral Adiposity Index (VAI) and Relative Fat Mass (RFM) indexes.

Results. It was found that the severity of VO in patients with NAFLD and NBW was comparable with patients who were overweight and obesity in indexes: Waist circumference / Hip circumference (WHR), VAI, presence of signs of severe dysfunction of Visceral adipose tissue (VAT), and the RFM index. In the group of patients with NAFLD and NBW, VAI correlated with the severity of liver fibrosis FIB‑4, and RFM with indicators characterizing liver damage.

Conclusion. The data obtained indicate the need to understand the pathogenetic features of the formation of a new NAFLD phenotype in order to develop effective therapy for this category of patients.

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