Visceral Fat is Better Related To Liver Function and Lipid Metabolism Than Body Mass Index and Waist Circumference: A Cross-Sectional Study

Abstract Objective: The role of visceral fat area (VFA) in the metabolism of lipid and liver function was not known. To compare and evaluate the correlation of VFA, waist circumference (WC) and Body mass index (BMI) measured by Bioelectrical impedance (BIA) in terms of lipid metabolism and liver function. Receiver operating characteristic curve (ROC curve), optimum cut-off points and odds ratio (OR) for liver function and lipid metabolism variables were recommended.Methods: A cross-sectional study was conducted on the subjects with the diagnose of obesity, including normal, overweight and obesity groups Direct Segmental Multi-Frequency Biolectrical Impedance technology was used to analysze body composition and biochemical indicators were tested. Participants were divided into normal and unnormal groups by lipid and liver indicators, cut off value of VFA and related variables was calculated by ROC analysis and multiple logistic regression analysis were conducted. Results: Ninety-five participants were enrolled in this study, fifty-seven (60%) were male, and the average age was thirty-four years old. Compared with normal group, high density lipoprotein (HDL) and low density lipoprotien (LDL) disorder groups have a higher VFA (normal HDL group 87.3cm2< unnormal HDL group 115.8cm2; normal LDL group 90.5cm2< unnormal LDL group 109.0cm2, p<0.05). VFA was higher in the lactate dehydrogenase (LDH) disorder group than in the normal, and the difference was significant (144.6cm2>96.2cm2, p=0.016). BMI, WC and VFA values was manifested positively correlated to glutamic oxaloacetic transaminase (AST) and alanine aminotransferase (ALT), respectively. Area under the curve (AUC) of VFA was over than 0.7 revealed great ability of related to lipid HDL metabolism (p=0.004). VFA (AUC= 0.701, 95% CI 0.577-0.826, p =0.004) provides a better diagnostic accuracy to distinguish between HDL disorder and normal groups. The optimal cut-off value for VFA was 80.2cm2 with 81.3% sensitivity and 56.8% specificity. For LDH disorder, a cut-off value of VFA 125.3 cm2 shows a sensitivity of 83.3% and specificity of 78.9% (AUC=0.792, 95% CI 0.595-0.989, p=0.019). The risk of lipid metabolism disorder and liver dysfunction were explored, and Multivariate analysis showed that VFA>80.2cm2 (OR=2.81, p=0.034) was a significantly risk factor related to HDL disorder and VFA>125.3cm2 (OR=18.75, P=0.01) was the risk factor for LDH disorder. While, WC and BMI wasn’t in the regression equation.Conclusion: VFA was more reliable and related to the lipid metabolism and liver function. VFA could be used as an independent indicator for the evaluation of the risk lipid metabolism disorder and liver dysfunction.