Higher liver fat content among Japanese in Japan compared with non-Hispanic whites in the United States

Koichiro Azuma, Takashi Kadowaki, Cemal Cetinel, Aya Kadota, Aiman El-Saed, Sayaka Kadowaki, Daniel Edmundowicz, Yoshihiko Nishio, Kim Sutton-Tyrrell, Tomonori Okamura, Rhobert W. Evans, Tomoko Takamiya, Hirotsugu Ueshima, J. David Curb, Robert D. Abbott, Lewis H. Kuller, David E. Kelley, Akira Sekikawa

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


Among Asians, including Japanese, obesity is related to dyslipidemia and insulin resistance at a lower level of body mass index (BMI) compared with non-Hispanic whites (NHW). We hypothesize that this ethnic difference in the relationship between BMI and metabolic risks is partly associated with the ethnic difference in fat distribution, namely, liver fat as well as visceral adipose tissue. To compare liver fat content among Japanese vs NHW men, regional computed tomographic images were taken to measure liver computed tomographic density in population-based samples of 313 Japanese and 288 NHW men aged 40 to 49 years, along with the assessment of metabolic parameters. Liver fat content was higher in Japanese than NHW men (liver to spleen attenuation ratio [lower value means higher liver fat content]: 1.01 ± 0.16 vs 1.07 ± 0.15, respectively; P < .01), despite a lower mean BMI in Japanese men (BMI: 23.6 ± 2.9 vs 27.8 ± 4.2 kg/m2, P < .01). Moreover, Japanese men had a greater disposition for fatty liver with a small increase in BMI than NHW (P < .01), whereas both groups had a similar relationship between visceral adipose tissue and BMI. In both groups, liver fat content correlated with triglycerides, homeostasis model assessment of insulin resistance, and C-reactive protein. Liver fat content is higher among Japanese than NHW; and this ethnic difference becomes more robust with a small increase in BMI, suggesting that fatty liver is a sensitive marker for the failure of the adipose tissue to expand to accommodate an increased energy influx, and is associated with similar metabolic risk in Japanese despite lower BMI compared with NHW men.

Original languageEnglish
Pages (from-to)1200-1207
Number of pages8
JournalMetabolism: clinical and experimental
Issue number8
Publication statusPublished - 2009 Aug 1
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


Dive into the research topics of 'Higher liver fat content among Japanese in Japan compared with non-Hispanic whites in the United States'. Together they form a unique fingerprint.

Cite this