Neck Circumference for NAFLD Assessment during a 2-Year Nutritional Intervention: The FLiO Study

Area of Science:

• Hepatology
• Metabolic Syndrome
• Nutritional Science

Background:

• Non-alcoholic fatty liver disease (NAFLD) is a growing health concern, particularly in obese populations.
• Non-invasive markers for assessing and managing NAFLD are crucial for effective clinical practice.
• Neck circumference (NC) and its ratios (NHtR, NWtR) are easily measurable anthropometric indicators.

Purpose of the Study:

• To evaluate the utility of routine variables, including neck circumference, in assessing and managing NAFLD.
• To determine the association of NC with steatosis degree and visceral adipose tissue over a 2-year intervention.
• To assess the predictive ability of NC-based models for hepatic fat content.

Main Methods:

• A 2-year nutritional intervention study involving 98 obese subjects with NAFLD.
• Regular measurements of anthropometric (including NC), metabolic (ALT, HOMA-IR), and imaging variables.
• Receiver Operating Characteristic (ROC) analysis to evaluate prediction models for hepatic steatosis.

Main Results:

• Nutritional intervention led to significant improvements in anthropometric, metabolic, and imaging variables.
• Neck circumference demonstrated significant associations with steatosis degree and visceral adipose tissue throughout the study.
• Models combining NC, neck ratios, ALT, and HOMA-IR, especially with weight loss, showed high predictive accuracy for hepatic steatosis (NC-ROC: 0.982).

Conclusions:

• Neck circumference and related ratios are valuable non-invasive tools for NAFLD assessment.
• Combining NC with metabolic markers (ALT, HOMA-IR) enhances the prediction of hepatic fat content.
• These markers can improve the clinical prevention and management strategies for NAFLD.