Epicardial fat thickness correlates with body fat stores, insulin resistance and alanine aminotransferase in patients affected by nonalcoholic steatohepatitis (NASH)

Introduction: Nonalcoholic steatohepatitis is frequently associated with obesity and metabolic syndrome. The aim of the present study was to evaluate the relationship between epicardial fat thickness, body composition, insulin resistance and alanine aminotransferase level in people affected by nonalcoholic steatohepatitis. Materials and methods: Fourteen adult male patients (body mass index [BMI] 28.8±2.0 kg/m2) with biopsy-proven nonalcoholic steatohepatitis were enrolled in the study; 14 healthy men were used as controls. All study participants underwent a clinical evaluation and an abdominal ultrasound examination. A blood sample was drawn after an overnight fast for determination of plasma glucose, insulin, HOMA-IR, blood lipids and parameters of liver and renal function. Epicardial fat thickness on the free wall of the right ventricle from both parasternal long- and short-axis views and left ventricular mass were measured by the same observer. Body composition was evaluated by anthropometry and dual-energy absorptiometry. Results: Epicardial fat thickness was greater in men with nonalcoholic steatohepatitis than in controls (7.9±2.1 vs 4.1±1.8 mm, p<0.001) and correlated positively with percentage body fat (p<0.001), BMI (p<0.001), waist circumference (p<0.001), HOMA-IR (p<0.01), and alanine aminotransferase level (p<0.01). Conclusion: The present study showed that epicardial fat thickness correlates with HOMA-IR and body fat stores in subjects affected by nonalcoholic steatohepatitis. Since weight reduction is able to reduce epicardial fat thickness in obese individuals, a correct dietary intervention program should decrease epicardial fat thickness and insulin resistance, thus reducing cardiovascular risk factors in patients with nonalcoholic steatohepatitis.