Obesity is a well established risk factor for hepatic steatosis and fibrotic liver disease. Nevertheless, abdominal fat distribution predicts metabolic abnormalities associated with obesity including hepatic steatosis. We aimed to investigate the relationship between body fat distribution and nonalcoholoic steatohepatitis (NASH).

25 patients with biopsy proven NASH and age-, sex-, and body mass index (BMI) matched 24 healthy individuals were studied. Patients divided into two groups according to BMI: Group I: BMI<30 (n=17), Group II: BMI≥30 (n=8). Total body fat (TBF) and trunkal fat (TF) were assessed using Dual-energy X-ray absorptiometry. Abdominal obesity was estimated by the percentage of TF, which is determined by (TF/TBF) x100.

The BMI, TBF, and TF were comparable in the control and NASH groups. TF/TBF ratio in patients with NASH, however, was significantly higher than that in the control group (p<0.05). Similarly, only TF/TBF ratio was higher in Group I than in the control group (p<0.01), although the BMI, TBF and TF values were comparable (p>0.05). The TF/TBF ratio in Group II (51.9±3.1%) was also higher than in the control group (49.9±5.9%) but the difference was not significant (p>0.05). Concerning the histopathological severity, neither grade nor stage of the patients with NASH was correlated with TF/TBF ratio (p>0.05).

Abdominal obesity is closely associated with NASH, in particular in non-obese overweight or lean patients.