Adipose Tissue Elastography, Anthropometric Parameters and Non-Alcoholic Fatty Liver Disease in Obese Adults: A Cross-Sectional Study
DOI:
https://doi.org/10.54133/ajms.v8i2.1782Keywords:
Anthropometry, Elastography, Obesity, Non-alcoholic fatty liver, Subcutaneous adipose tissueAbstract
Background: Obesity is recognized as a significant global health crisis, with over a third of the world's population affected, posing severe health and economic challenges. Objectives: To investigate the differences in subcutaneous adipose tissue (SAT) characteristics, specifically thickness and stiffness, between young (20-39 years) and middle-aged (40-59 years) obese individuals and examine sex-specific variations and associations with non-alcoholic fatty liver disease (NAFLD). Methods: One hundred obese participants were evaluated using anthropometric measurements (body mass index and waist-height ratio) and ultrasonic shear wave elastography to assess NAFLD and SAT structure across three anatomical sites. Results: Participants in their middle years had stiffer SATs, especially in the upper abdomen and distal triceps. However, there were no significant differences in BMI, waist-to-height ratio, or SAT thickness at the mid-thigh based on age. Additionally, NAFLD prevalence was found in 31 participants, with a notable correlation between its presence and SAT thickness & obesity metrics, although SAT stiffness did not significantly correlate with NAFLD. Conclusions: The dynamic nature of SAT as it relates to aging and sex, emphasizing the need for tailored therapeutic approaches in managing obesity and associated metabolic disorders. According to this study, elastography could be a non-invasive way to check for organ damage due to obesity and could aid in the prediction of NAFLD when combined with routine body measurements. Further research is warranted to refine assessment methodologies and validate anatomical site representativeness.
Downloads
References
Islam AS, Sultana H, Refat MN, Farhana Z, Kamil AA, Rahman MM. The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis. Prevent Med Rep. 2024:102882. doi: 10.1016/j.pmedr.2024.102882. DOI: https://doi.org/10.1016/j.pmedr.2024.102882
De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? J Transl Med. 2019;17:1-3. doi:10.1186/s12967-019-1919-y. DOI: https://doi.org/10.1186/s12967-019-1919-y
Omer TA. The causes of obesity: an in-depth review. Adv Obes Weight Manag Control. 2020;10(4):90-94. doi: 10.15406/aowmc.2020.10.00312. DOI: https://doi.org/10.15406/aowmc.2020.10.00312
Engin A. The definition and prevalence of obesity and metabolic syndrome: Correlative clinical evaluation based on phenotypes. Adv Exp Med Biol. 2024;1460:1-25. doi: 10.1007/978-3-031-63657-8_1. DOI: https://doi.org/10.1007/978-3-031-63657-8_1
Cornier MA. A review of current guidelines for the treatment of obesity. Am J Manag Care. 2022;28. doi:10.1007/978-3-031-63657-8_1. DOI: https://doi.org/10.37765/ajmc.2022.89292
Sommer I, Teufer B, Szelag M, Nussbaumer-Streit B, Titscher V, Klerings I, et al. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep. 2020;10(1):12699. doi: 10.1038/s41598-020-69498-7. DOI: https://doi.org/10.1038/s41598-020-69498-7
Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, et al. Aging and imaging assessment of body composition: from fat to facts. Front Endocrinol. 2020;10:861. doi: 10.3389/fendo.2019.00861. DOI: https://doi.org/10.3389/fendo.2019.00861
Abou Karam M, Mukhina E, Daras N, Rivals I, Pillet H, Skalli W, et al. Reliability of B-mode ultrasound and shear wave elastography in evaluating sacral bone and soft tissue characteristics in young adults with clinical feasibility in elderly. J Tissue Viability. 2022;31(2):245-254. doi: 10.1016/j.jtv.2022.02.003. DOI: https://doi.org/10.1016/j.jtv.2022.02.003
Zarrad M, Duflos C, Marin G, Benhamou M, Laroche JP, Dauzat M, et al. Skin layer thickness and shear wave elastography changes induced by intensive decongestive treatment of lower limb lymphedema. Lymph Res Biol. 2022;20(1):17-25. doi: 0.1089/lrb.2021.0036.
Ou MY, Zhang H, Tan PC, Zhou SB, Li QF. Adipose tissue aging: mechanisms and therapeutic implications. Cell Death Dis. 2022;13(4):300. doi:10.1038/s41419-022-04752-6. DOI: https://doi.org/10.1038/s41419-022-04752-6
Müller W, Lohman TG, Stewart AD, Maughan RJ, Meyer NL, Sardinha LB, et al. Subcutaneous fat patterning in athletes: selection of appropriate sites and standardisation of a novel ultrasound measurement technique: ad hoc working group on body composition, health and performance, under the auspices of the IOC Medical Commission. Br J Sports Med. 2016;50(1):45-54. doi: 10.1136/bjsports-2015-095641. DOI: https://doi.org/10.1136/bjsports-2015-095641
Shiralkar K, Johnson S, Bluth EI, Marshall RH, Dornelles A, Gulotta PM. Improved method for calculating hepatic steatosis using the hepatorenal index. J Ultrasound Med. 2015;34(6):1051-1059. doi: 10.7863/ultra.34.6.1051. DOI: https://doi.org/10.7863/ultra.34.6.1051
Tada T, Nishimura T, Yoshida M, Iijima H. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: new trends and role of ultrasonography. J Med Ultrason (2001). 2020;47(4):511-520. doi: 10.1007/s10396-020-01058-y. DOI: https://doi.org/10.1007/s10396-020-01058-y
Palmer AK, Kirkland JL. Aging and adipose tissue: potential interventions for diabetes and regenerative medicine. Exp Gerontol. 2016;86:97-105. doi: 10.1016/j.exger.2016.02.013. DOI: https://doi.org/10.1016/j.exger.2016.02.013
Cai Z, He B. Adipose tissue aging: An update on mechanisms and therapeutic strategies. Metabolism. 2023;138:155328. doi: 10.1016/j.metabol.2022.155328. DOI: https://doi.org/10.1016/j.metabol.2022.155328
Pérez LM, Pareja‐Galeano H, Sanchis‐Gomar F, Emanuele E, Lucia A, Gálvez BG. ‘Adipaging’: ageing and obesity share biological hallmarks related to a dysfunctional adipose tissue. J Physiol. 2016;594(12):3187-3207. doi: 10.1113/JP271691. DOI: https://doi.org/10.1113/JP271691
Zoico E, Rubele S, De Caro A, Nori N, Mazzali G, Fantin F, et al. Brown and beige adipose tissue and aging. Front Endocrinol. 2019;10:368. doi: 10.3389/fendo.2019.00368. DOI: https://doi.org/10.3389/fendo.2019.00368
Nuttall FQ. Body mass index: obesity, BMI, and health: a critical review. Nutr Today. 2015;50(3):117-128. doi: 10.1097/NT.0000000000000092. DOI: https://doi.org/10.1097/NT.0000000000000092
Buechler C, Krautbauer S, Eisinger K. Adipose tissue fibrosis. World J Diabetes. 2015;6(4):548. doi: 10.4239/wjd.v6.i4.548. DOI: https://doi.org/10.4239/wjd.v6.i4.548
Ruiz-Ojeda FJ, Méndez-Gutiérrez A, Aguilera CM, Plaza-Díaz J. Extracellular matrix remodeling of adipose tissue in obesity and metabolic diseases. Int J Mol Sci. 2019;20(19):4888. doi: 10.3390/ijms20194888. DOI: https://doi.org/10.3390/ijms20194888
Orsso CE, Colin-Ramirez E, Field CJ, Madsen KL, Prado CM, Haqq AM. Adipose tissue development and expansion from the womb to adolescence: an overview. Nutrients. 2020;12(9):2735. doi: 10.3390/nu12092735. DOI: https://doi.org/10.3390/nu12092735
Bredella MA. Sex differences in body composition. In: Mauvais-Jarvis, F. (eds.) Sex and Gender Factors Affecting Metabolic Homeostasis, Diabetes and Obesity. Advances in Experimental Medicine and Biology, 2027;1043. Springer, Cham. doi: 10.1007/978-3-319-70178-3_2. DOI: https://doi.org/10.1007/978-3-319-70178-3_2
Muscogiuri G, Verde L, Vetrani C, Barrea L, Savastano S, Colao A. Obesity: a gender-view. J Endocrinol Invest. 2024;47(2):299-306. doi: 10.1007/s40618-023-02196-z. DOI: https://doi.org/10.1007/s40618-023-02196-z
Cooper AJ, Gupta SR, Moustafa AF, Chao AM. Sex/gender differences in obesity prevalence, comorbidities, and treatment. Curr Obes Rep. 2021;10(4):458-466. doi: 10.1007/s13679-021-00453-x. DOI: https://doi.org/10.1007/s13679-021-00453-x
Wang Y, Beydoun MA, Min J, Xue H, Kaminsky LA, Cheskin LJ. Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. Int J Epidemiol. 2020;49(3):810-823. doi: 10.1093/ije/dyz273. DOI: https://doi.org/10.1093/ije/dyz273
Vilalta A, Gutiérrez JA, Chaves S, Hernández M, Urbina S, Hompesch M. Adipose tissue measurement in clinical research for obesity, type 2 diabetes and NAFLD/NASH. Endocrinol Diabetes Metab. 2022;5(3):e00335. doi: 10.1002/edm2.335. DOI: https://doi.org/10.1002/edm2.335
Namgoung S, Chang Y, Woo CY, Kim Y, Kang J, Kwon R, et al. Metabolically healthy and unhealthy obesity and risk of vasomotor symptoms in premenopausal women: cross-sectional and cohort studies. BJOG. 2022;129(11):1926-1934. doi: 10.1111/1471-0528.17224. DOI: https://doi.org/10.1111/1471-0528.17224
Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, Yang W, et al. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord. 2022;22(1):63. doi: 10.1186/s12902-022-00980-1. DOI: https://doi.org/10.1186/s12902-022-00980-1
Heyens LJ, Busschots D, Koek GH, Robaeys G, Francque S. Liver fibrosis in non-alcoholic fatty liver disease: from liver biopsy to non-invasive biomarkers in diagnosis and treatment. Front Med. 2021;8:615978. doi: 10.3389/fmed.2021.615978. DOI: https://doi.org/10.3389/fmed.2021.615978
Kühn T, Nonnenmacher T, Sookthai D, Schübel R, Quintana Pacheco DA, et al. Anthropometric and blood parameters for the prediction of NAFLD among overweight and obese adults. BMC Gastroenterol. 2018;18(1):113. doi: 10.1186/s12876-018-0840-9. DOI: https://doi.org/10.1186/s12876-018-0840-9
Reis SS, Callejas GH, Marques RA, Gestic MA, Utrini MP, Chaim FDM, et al. Correlation between anthropometric measurements and non-alcoholic fatty liver disease in individuals with obesity undergoing bariatric surgery: Cross-sectional study. Obes Surg. 2021;31(8):3675-3685. doi: 10.1007/s11695-021-05470-2. DOI: https://doi.org/10.1007/s11695-021-05470-2
Cai J, Lin C, Lai S, Liu Y, Liang M, Qin Y, et al. Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population. Lipids Health Dis. 2021;20(1):145. doi: 10.1186/s12944-021-01568-9. DOI: https://doi.org/10.1186/s12944-021-01568-9

Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 )

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Published by Al-Rafidain University College. This is an open access journal issued under the CC BY-NC-SA 4.0 license (https://creativecommons.org/licenses/by-nc-sa/4.0/).