中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 42 Issue 2
Feb.  2026
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2026  >  42(2): 312-318

Impact of visceral fat area on significant liver fibrosis in patients with nonalcoholic fatty liver disease and establishment of a predictive model

DOI: 10.12449/JCH260211
  • 1.

    The Second Clinical Medical College of Guangzhou University of Chinese Medicine，Guangzhou 510405，China

  • 2.

    Department of Hepatology，The Second Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangdong Provincial Hospital of Traditional Chinese Medicine，Guangzhou 510120，China

  • 3.

    Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndromes，Guangzhou 510120，China

  • 4.

    Guangdong Provincial Laboratory of Traditional Chinese Medicine，Zhuhai，Guangdong 519000，China

  • 5.

    Guangdong Provincial Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases，Zhuhai，Guangdong 519031，China

Research funding:

Chi Xiaoling National Famous Traditional Chinese Medicine Expert Inheritance Studio（Teaching Letter from State Traditional Chinese Medicine Office (2022-75);

The Specific Research Fund for TCM Science and Technology of Guangdong Provincial Hospital of Chinese Medicine (YN2022QN05);

The Specific Research Fund for TCM Science and Technology of Guangdong Provincial Hospital of Chinese Medicine (YN10101903);

The Specific Research Fund for TCM Science and Technology of Guangdong Provincial Hospital of Chinese Medicine (YN2022DB04);

Guangdong Provincial Hospital of Traditional Chinese Medicine Specialized Programs for Key Diseases (the Second Hospital of Chinese Medicine （2017）86);

Guangdong Provincial Hospital of Traditional Chinese Medicine Specialized Programs for Key Diseases (the Second Hospital of Chinese Medicine （2020）37);

Guangdong Provincial Basic and Applied Basic Research Fund Project (2022A1515110825);

Guangdong Provincial Basic and Applied Basic Research Fund Project (2022A1515220188);

Guangdong Provincial Basic and Applied Basic Research Fund Project (2023A1515011092);

Guangdong Provincial Science and Technology Program Projects (2023B1212060063);

Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases, Guangdong Province Funded Project (YN2023MB04);

Science and Technology R & D Incubation Project of Guangdong Laboratory of Traditional Chinese Medicine （Hengqin Laboratory） (HQL2024PZ033)

More Information
  • Corresponding author: CHI Xiaoling， chixiaolingqh@163.com （ORCID： 0000-0003-3193-1943）
  • Received Date: 2025-09-20
  • Accepted Date: 2025-11-24
  • Published Date: 2026-02-25
    Abstract
  •   Objective  To investigate whether visceral fat area （VFA） is an independent risk factor for significant liver fibrosis in patients with nonalcoholic fatty liver disease （NAFLD） based on clinical data， and to establish an effective diagnostic model.  Methods  A total of 222 NAFLD patients who attended Department of Hepatology， Guangdong Provincial Hospital of Traditional Chinese Medicine， from January 2021 to April 2025 were enrolled， and according to liver stiffness measurement （≥8 kPa or not）， they were divided into significant fibrosis group and non-significant fibrosis group. Propensity score matching （PSM） was performed at a ratio of 1∶1 to balance the baseline data between the two groups. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was used to determine the correlation of VFA and other indicators with significant liver fibrosis； univariate and multivariate logistic regression analyses were used to identify whether VFA was an independent risk factor for significant liver fibrosis in NAFLD patients， and the receiver operating characteristic （ROC） curve was plotted to assess the predictive performance of related indicators.  Results  A total of 45 patients with significant liver fibrosis and 177 patients without significant liver fibrosis were enrolled， and after PSM， 90 patients （45 pairs） were finally included in analysis. Compared with the non-significant fibrosis group， the significant fibrosis group had significantly higher levels of body mass index （BMI）， fasting blood glucose （FBG）， glycated hemoglobin （HbA1c）， uric acid （UA）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， gamma-glutamyl transpeptidase （GGT）， controlled attenuation parameter （CAP）， and VFA， as well as a significantly higher proportion of patients with visceral fat obesity or three or more metabolic risk factors （all P<0.05）. VFA， BMI， AST， and HbA1c were strongly correlated with significant liver fibrosis （all r>0.5， all P <0.05）， and ALT， GGT， UA， FBG， and CAP were significantly positively correlated with significant liver fibrosis （r=0.3　—　0.5， all P<0.05）. VFA （odds ratio ［OR］=1.040， 95% confidence interval ［CI］： 1.018　—　1.062， P<0.05）， FBG （OR=2.372， 95%CI： 1.199　—　4.691， P<0.05）， and AST （OR=1.032， 95%CI： 1.003　—　1.058， P<0.05） were independent risk factors for significant liver fibrosis in NAFLD patients. The new diagnostic model based on VFA， FBG， and AST （with an area under the ROC curve ［AUC］ of 0.907） had a significantly better performance than aspartate aminotransferase-to-platelet ratio index （AUC=0.834）， fibrosis-4 （AUC=0.660）， triglyceride-glucose index （AUC=0.656）， and NAFLD fibrosis score （AUC=0.768） in predicting significant liver fibrosis in NAFLD patients （all P<0.05）.  Conclusion  VFA is an independent risk factor for significant liver fibrosis in NAFLD patients， and the noninvasive diagnostic model based on VFA， FBG， and AST can effectively predict the onset of significant liver fibrosis in NAFLD patients.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    Hepatology Branch of Chinese Medical Association. Guidelines for prevention and treatment of metabolic-related(nonalcoholic) fatty liver disease(2024 edition)[J]. J Pract Hepatol, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.

    中华医学会肝病学分会. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 实用肝脏病杂志, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.
    [2]
    ANGULO P, KLEINER DE, DAM-LARSEN S, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease[J]. Gastroenterology, 2015, 149( 2): 389- 397. e 10. DOI: 10.1053/j.gastro.2015.04.043.
    [3]
    DULAI PS, SINGH S, PATEL J, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis[J]. Hepatology, 2017, 65( 5): 1557- 1565. DOI: 10.1002/hep.29085.
    [4]
    KIM D, CHUNG GE, KWAK MS, et al. Effect of longitudinal changes of body fat on the incidence and regression of nonalcoholic fatty liver disease[J]. Dig Liver Dis, 2018, 50( 4): 389- 395. DOI: 10.1016/j.dld.2017.12.014.
    [5]
    YU SJ, KIM W, KIM D, et al. Visceral obesity predicts significant fibrosis in patients with nonalcoholic fatty liver disease[J]. Medicine, 2015, 94( 48): e2159. DOI: 10.1097/MD.0000000000002159.
    [6]
    National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: A 2018 update[J]. J Clin Hepatol, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.

    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 临床肝胆病杂志, 2018, 34( 5): 947- 957. DOI: 10.3969/j.issn.1001-5256.2018.05.007.
    [7]
    Chinese Society of Health Management; Clinical Nutrition Branch of Chinese Nutrition Society; Medical Nutrition Industry Branch of the National Association of Health Industry and Enterprise Management, et al. Expert consensus on weight management process for overweight or obese people(2021)[J]. Chin J Health Manag, 2021, 15( 4): 317- 322. DOI: 10.3760/cma.j.cn115624-20210630-00368.

    中华医学会健康管理学分会, 中国营养学会临床营养分会, 全国卫生产业企业管理协会医学营养产业分会, 等. 超重或肥胖人群体重管理流程的专家共识(2021年)[J]. 中华健康管理学杂志, 2021, 15( 4): 317- 322. DOI: 10.3760/cma.j.cn115624-20210630-00368.
    [8]
    CHEN N, GENG N, LI J. Mechanisms and clinical practice advances in weight reduction for patients with metabolic associated fatty liver disease[J/CD]. Chin J Liver Dis: Electronic Edition, 2025, 17( 3): 10- 16. DOI: 10.3969/j.issn.1671-4695.2025.01.026.

    陈楠, 耿楠, 李婕. 代谢相关脂肪性肝病患者减重治疗机制与临床实践进展[J/CD]. 中国肝脏病杂志(电子版), 2025, 17( 3): 10- 16. DOI: 10.3969/j.issn.1671-4695.2025.01.026.
    [9]
    DESPRÉS JP, LEMIEUX I. Abdominal obesity and metabolic syndrome[J]. Nature, 2006, 444( 7121): 881- 887. DOI: 10.1038/nature05488.
    [10]
    EGUCHI Y, MIZUTA T, SUMIDA Y, et al. The pathological role of visceral fat accumulation in steatosis, inflammation, and progression of nonalcoholic fatty liver disease[J]. J Gastroenterol, 2011, 46( Suppl 1): 70- 78. DOI: 10.1007/s00535-010-0340-3.
    [11]
    VARGHESE J, DEVADAS K, JOSEPH RC, et al. Assessment of visceral fat volume and its correlation with the severity of hepatic fibrosis in patients with NAFLD[J]. J Assoc Physicians India, 2022, 70( 9): 11- 12. DOI: 10.5005/japi-11001-0097.
    [12]
    IDILMAN IS, LOW HM, GIDENER T, et al. Association between visceral adipose tissue and non-alcoholic steatohepatitis histology in patients with known or suspected non-alcoholic fatty liver disease[J]. J Clin Med, 2021, 10( 12): 2565. DOI: 10.3390/jcm10122565.
    [13]
    AUSTIN PC. Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples[J]. Stat Med, 2009, 28( 25): 3083- 3107. DOI: 10.1002/sim.3697.
    [14]
    ROSENBAUM PR, RUBIN DB. The central role of the propensity score in observational studies for causal effects[J]. Biometrika, 1983, 70( 1): 41- 55. DOI: 10.1093/biomet/70.1.41.
    [15]
    LONARDO A, NASCIMBENI F, MAURANTONIO M, et al. Nonalcoholic fatty liver disease: Evolving paradigms[J]. World J Gastroenterol, 2017, 23( 36): 6571- 6592. DOI: 10.3748/wjg.v23.i36.6571.
    [16]
    XUAN YY, WU DT, ZHANG Q, et al. Elevated ALT/AST ratio as a marker for NAFLD risk and severity: Insights from a cross-sectional analysis in the United States[J]. Front Endocrinol, 2024, 15: 1457598. DOI: 10.3389/fendo.2024.1457598.
    [17]
    ZHANG YX, WANG Y, YOU CL, et al. Analysis of related factors of abnormal liver function in patients with non-alcoholic fatty liver disease[J]. Chin J Med Offic, 2025, 53( 5): 522- 524, 528. DOI: 10.16680/j.1671-3826.2025.05.21.

    张月霞, 王宇, 尤丛蕾, 等. 非酒精性脂肪肝患者肝功能异常相关因素分析[J]. 临床军医杂志, 2025, 53( 5): 522- 524, 528. DOI: 10.16680/j.1671-3826.2025.05.21.
    [18]
    JI XQ, LIU A, SUN YB, et al. Correlation analysis of visceral fat area and liver function related indexes based on quantitative CT[J]. J Clin Radiol, 2025, 44( 6): 1107- 1111. DOI: 10.13437/j.cnki.jcr.2025.06.024.

    季晓琪, 刘澳, 孙永兵, 等. 基于定量CT对内脏脂肪面积与肝功能相关指标的相关性分析[J]. 临床放射学杂志, 2025, 44( 6): 1107- 1111. DOI: 10.13437/j.cnki.jcr.2025.06.024.
    [19]
    BENNETT NR, FERGUSON TS, BENNETT FI, et al. High-sensitivity C-reactive protein is related to central obesity and the number of metabolic syndrome components in Jamaican young adults[J]. Front Cardiovasc Med, 2014, 1: 12. DOI: 10.3389/fcvm.2014.00012.
    [20]
    PONCE-DE-LEON M, HANNEMANN A, LINSEISEN J, et al. Links between ectopic and abdominal fat and systemic inflammation: New insights from the SHIP-Trend study[J]. Dig Liver Dis, 2022, 54( 8): 1030- 1037. DOI: 10.1016/j.dld.2022.02.003.
    [21]
    LUO JQ, WANG Y, MAO JX, et al. Features, functions, and associated diseases of visceral and ectopic fat: A comprehensive review[J]. Obesity, 2025, 33( 5): 825- 838. DOI: 10.1002/oby.24239.
    [22]
    GUO L, TANG QQ. Research progress of the mechanism and therapy of non-alcoholic fatty liver disease[J]. Chin Bull Life Sci, 2018, 30( 11): 1165- 1172. DOI: 10.13376/j.cbls/2018141.

    郭亮, 汤其群. 非酒精性脂肪肝发病机制和治疗的研究进展[J]. 生命科学, 2018, 30( 11): 1165- 1172. DOI: 10.13376/j.cbls/2018141.
    [23]
    SI KY, HU Y, WANG ML, et al. Weight loss strategies, weight change, and type 2 diabetes in US health professionals: A cohort study[J]. PLoS Med, 2022, 19( 9): e1004094. DOI: 10.1371/journal.pmed.1004094.
    [24]
    SZTANEK F, TÓTH LI, PETŐ A, et al. New developments in pharmacological treatment of obesity and type 2 diabetes-beyond and within GLP-1 receptor agonists[J]. Biomedicines, 2024, 12( 6): 1320. DOI: 10.3390/biomedicines12061320.
    [25]
    YANG B, ZHANG R. Progress on the treatment of metabolic associated fatty liver disease[J/OL]. Chin J Liver Dis: Electronic Edition, 2024, 16( 4): 25- 30. DOI: 10.3969/j.issn.1674-7380.2024.04.004.

    杨彬, 张瑞. 代谢相关脂肪性肝病治疗进展[J/OL]. 中国肝脏病杂志(电子版), 2024, 16( 4): 25- 30. DOI: 10.3969/j.issn.1674-7380.2024.04.004.
    [26]
    DUAN YJ, FENG WH, SUN XT, et al. Cognitive improvement following bariatric surgery is associated with enhanced hippocampal activation and reduction in visceral and ectopic fat deposition[J]. Obes Surg, 2025, 35( 8): 2867- 2876. DOI: 10.1007/s11695-025-07964-9.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (37) PDF downloads(14) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return