Proton magnetic resonance spectroscopy (MRS) provides an accurate quantification of liver fat, but the threshold of 5.5% for “normal” is challenged. We evaluated the relationship between liver fat content and metabolic parameters to explore what might be a metabolically healthy liver fat content. We analyzed data from adult participants in the Dallas Heart Study who underwent clinical evaluation and liver fat quantification by MRS. We compared metabolic characteristics across groups stratified by liver fat quintiles using ANOVA for normal continuous variables, Kruskal-Wallis test for non-normal continuous variables, and Chi-square test for categorical variables. Mean age of the entire cohort was 44 years and 47% were men. Metabolic abnormalities were more prevalent across liver fat quintiles (p<0.0001) : BMI, weight, waist circumference, HTN, diabetes, cholesterol, triglycerides, CRP, leptin, fasting glucose, HOMA-IR, coronary artery calcium score, visceral fat, abdominal subcutaneous adipose tissue, and lower body subcutaneous adipose tissue (table) . Increase in these metabolic abnormalities was noticeable even between the lowest two quintiles. Clinically relevant metabolic abnormalities increased across all quintiles of liver fat, with increment occurring at well below what is currently considered “normal.” Our findings suggest that the presence of any liver fat may be abnormal.


M.Le: None. E.Wu: None. J.Berry: Consultant; Cooper Institute, Roche Diagnostics, Research Support; Abbott Diagnostics. J.Browning: None. J.Delemos: Advisory Panel; Eli Lilly and Company, Novo Nordisk. I.Neeland: Advisory Panel; Boehringer Ingelheim International GmbH, Merck & Co., Inc., Consultant; Nestlé Health Science. I.Lingvay: Advisory Panel; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly, Mannkind, TARGET PharmaSolutions; Valeritas;; Altimmune; DataRevive; Click; Medscape Duke CRI; Janssen Pharma; Bayer; Intercept, Novo Nordisk, Sanofi, Zealand Pharma A/S, Consultant; Novo Nordisk, Research Support; NovoNordisk; Mylan; Merck, Sanofi.

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