Comparison of Bio-Electrical Impedance Analysis, BMI and Waist Circumference in Assessing the Risk of Nonalcoholic Steatohepatitis: Predicting NASH using Non-Invasive Measurements

Abstract Objective Non-alcoholic fatty liver disease is a leading cause of liver disease worldwide and includes nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Since NASH is associated with obesity severity, routine evaluation of obesity/body fat in clinical settings may help detect patients at risk. This study aims to determine if assessing body fat by bioelectrical impedance analysis (BIA) is superior to body mass index (BMI) and waist circumference (WC) in assessing the risk of NASH. Research Methods and Procedures In this cross-sectional study, subjects were recruited and consented from a local hospital. All had a liver biopsy. Measurements prior to the biopsy included BMI, WC and BIA. BIA was used to measure percentage body fat and fat mass (kg). Based on histology, subjects were grouped into simple steatosis (SS), NASH or normal liver (NL). Results 139 subjects participated 39 SS, 53 NASH and 47 NL. Regardless of sex, patients with NASH had significantly higher BMI, WC, percentage body fat and fat mass compared to those with NL or SS. These four parameters were significantly positively correlated with liver histology measurements. In all subjects, when controlling for sex and age we found that BMI, WC and BIA were equal at predicting the presence of NASH (p-value 0.0571). Conclusion All three methods, BIA, BMI or WC, were comparable in assessing the risk of NASH. For practical purpose in clinical settings, using BMI is acceptable.