It’s not just weight that’s a concern for people with fatty liver disease; waist circumference is just as important!

With the improvement of modern living standards, people’s dietary patterns and lifestyles have changed greatly. Obesity, fatty liver disease and other diseases are becoming more common, posing a great challenge to human health.

1.Fatty liver patients must pay attention to weight changes

Weight is closely related to chronic liver disease. Both malnutrition and obesity can contribute to fatty liver, leading to elevated liver transaminases. The greater and longer the deviation of weight and body mass index (BMI) from the normal range, the greater the likelihood of liver damage.

In both emaciated and normal weight individuals, short-term weight gain without meeting the diagnostic criteria for overweight and obesity may lead to the development of fatty liver and metabolic disorders. Particularly in postmenopausal women with a sharp decline in estrogen levels, any mild weight gain can lead to the development of metabolic syndrome, with a high likelihood of fatty liver and hepatic fibrosis.
There are also low birth weight babies who are overfed during infancy and childhood, resulting in overnutrition and catch-up weight gain, and will be more likely to develop fatty liver and metabolic disorders as children and adolescents than children of the same weight.

2.Fatty liver patients need to pay attention to changes in waist circumference

Waist circumference is closely related to metabolic syndrome. Waist circumference reflects to some extent the amount of visceral fat. Some studies have shown that there is a linear relationship between waist circumference and the severity of fatty liver; the larger the waist circumference, the more fat is deposited in the liver.
Therefore, even if a person does not look fat, as long as the abdomen is bulging, the so-called “general belly”, it is very likely to be patients with fatty liver, must do ultrasound examination of the liver, determine the content of liver fat, liver function, glucose, blood lipid test.

Generally speaking, a body mass index (BMI) of more than 24kg/m2 is considered overweight, and more than 28kg/m2 is considered obese, in which men with a waist circumference of more than 90cm and women with a waist circumference of more than 80cm are considered abdominally obese, and the fat is mainly distributed in the viscera and upper abdominal subcutaneous area, also known as central obesity.
If the fat is mainly distributed in the lower abdomen, buttocks and femur subcutaneous, known as peripheral obesity. The risk of metabolic syndrome is higher in central obesity, while it is more difficult to lose weight in patients with peripheral obesity. Therefore, we must not wait until the onset of severe obesity, or even after the onset of complications, before starting to pay attention to weight control and waist circumference.

3.Fatty liver patients are also tested for upper arm muscle circumference, hip circumference, blood pressure, etc.

Patients with fatty liver disease who have a low body mass index need additional measurements of upper arm circumference, biceps circumference, triceps skinfold thickness, and grip strength to determine muscle tissue and fat storage and to clarify the presence or absence of sarcopenia. Hip circumference should be measured to calculate the waist-to-hip ratio, and height should be measured to calculate the waist-to-height ratio.
The waist-to-height ratio should not exceed 0.5 for people under 40 years of age, 0.5-0.6 for people between 40 and 50 years of age, and 0.6 for people over 50 years of age. The upper limit of the waist-to-hip ratio is 0.85-0.9 for men and 0.75-0.8 for women, beyond which abdominal obesity can be defined. Some studies show that for every 10 cm increase in waist circumference, the risk of all-cause mortality increases by 11 percent; and for every 0.1 unit increase in waist-to-hip ratio, the risk of mortality increases by 20 percent. This is more pronounced in women.

Many people with fatty liver have high blood pressure. Therefore, it is very important to monitor blood pressure. Blood pressure control is critical for preventing cardiovascular disease.
In addition, patients with fatty liver should be concerned about the presence of thinning and loss of hair, muscle wasting, yellowing of the skin and sclera, ecchymosis and petechiae of the skin, acanthosis nigricans, blepharoplastoma, spider nevus, hepatomegaly, gynecomastia, enlarged liver and spleen, ascites, and lower limb edema.
Regular measurement of body weight and waist circumference combined with 24-hour urine output for early detection of ascites and lower limb edema and early detection of possible cirrhosis.