Dear Sir,
I read with a great interest the recent article by Eguchi et al. [1]. The article has important outcomes related with visceral fat accumulation (VAT) and nonalcoholic fatty liver disease (NAFLD). But, there is an issue of my concern. The item of subcutaneous adipose tissue (SAT) is missing in the present study. Failure of adipocytes to increase number in SAT as body fat increases might lead to fat accumulation in tissues such as VAT and liver—all known to contribute to insulin resistance [2]. A reduced lipo-/adipogenic capacity and large subcutaneous adipocytes might contribute to the abnormal distribution of abdominal fat and hepatic steatosis, as well as to insulin resistance [3]. Did the authors observe a difference in the outcomes of study parameters between the persons with different VAT and SAT ratios?
References
Eguchi Y, Mizuta T, Sumida Y, Ishibashi E, Kitajima Y, Isoda H, et al. The pathological role of visceral fat accumulation in steatosis, inflammation, and progression of nonalcoholic fatty liver disease. J Gastroenterol. 2010;46(S1):70–8.
Pasarica M, Xie H, Hymel D, Bray G, Greenway F, Ravussin E, Smith SR. Lower total adipocyte number but no evidence for small adipocyte depletion in patients with type 2 diabetes. Diabetes Care. 2009;32(5):900–2.
Kursawe R, Eszlinger M, Narayan D, Liu T, Bazuine M, Cali AM, D’Adamo E, et al. Cellularity and adipogenic profile of the abdominal subcutaneous adipose tissue from obese adolescents: association with insulin resistance and hepatic steatosis. Diabetes. 2010;59(9):2288–96.
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An answer to this letter to the editor is available at doi:10.1007/s00535-010-0363-9.
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Filik, L. Visceral and subcutaneous fat accumulation and nonalcoholic fatty liver disease. J Gastroenterol 46, 418 (2011). https://doi.org/10.1007/s00535-010-0362-x
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DOI: https://doi.org/10.1007/s00535-010-0362-x