Neck circumference and ratios: a low-cost alternative for the assessment of steatosis?

Magnetic resonance imaging (MRI) is the most sensitive and specific non-invasive tool (NIT) for the evaluation and quantification of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). However, it remains a relatively expensive tool, and is not routinely used in clinical practice.
PUBLISHED IN: Nutrients 2022

Comment:

Magnetic resonance imaging (MRI) is the most sensitive and specific non-invasive tool (NIT) for the evaluation and quantification of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). However, it remains a relatively expensive tool, and is not routinely used in clinical practice. As such, achieving early diagnoses in patients with NAFLD is a difficult feat, and new inexpensive NITs able to rapidly predict the disease in its early stages are urgently needed.

Anthropometric measurements, which include neck circumference (NC), neck-to-height (NHtR), and neck-to-weight (NWtR) ratios, have been suggested as potential markers able to effectively detect NAFLD.

The aim of this study was to investigate the ability of NC and neck ratios to assess liver fat content in 98 patients with NAFLD during a 2-year nutritional intervention program.

Key learnings:

NC was found to be significantly associated with steatosis degree and visceral adipose tissue. NC effectively measures deposition of subcutaneous fat in the neck, and upper body obesity has been linked to NAFLD-related metabolic abnormalities.

Combining NC with neck ratios, ALT level measurements, and the Homeostasis Model Assessment Index (HOMA-IR) was found to predict hepatic fat content and steatosis degree at all study time-points. This predictive ability increased when weight loss was also considered. These findings suggest that NC and neck ratios may be clinically relevant markers for the prevention and management of NAFLD. Future studies should seek to confirm these variables’ predictive validity and assess their diagnostic sensitivity.

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S Duarte, BSc

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