Weight change and the development of non-alcoholic fatty liver disease in metabolically healthy overweight individuals
Weight change and the development of non-alcoholic fatty liver disease in metabolically healthy overweight individuals
Introduction: The study sought to investigate the effect of weight change on hepatic steatosis (HS) incidence with or without liver fibrosis in metabolically healthy overweight or obese individuals. Methods: A cohort of 14,779 metabolically healthy men and women who were overweight or obese (body mass index ≥23 kg/m
2) and free from HS and an intermediate or high probability of fibrosis at baseline were followed for a median of 5.2 years. Metabolic health was defined as freedom from the components of metabolic syndrome and a homeostatic model assessment of insulin resistance <2.5. Weight changes were calculated as differences from baseline at the next subsequent visit. The outcome was HS incidence, with or without liver fibrosis, as assessed by liver ultrasound and 2 noninvasive fibrosis scores. Results: During 76,794.6 person-years of follow-up, 3539 cases of HS incidence were identified. The multivariable adjusted hazard ratios (95% confidence intervals) for HS incidence by weight change group, <–5.0%, –5.0%–1.0%, 1.0%–5.0%, and >5.0%, relative to the no weight change group (–0.9% to 0.9%) were 0.52 (0.44–0.60), 0.83 (0.75–0.92), 1.21 (1.10–1.33), and 1.51 (1.36–1.69), respectively. Clinically relevant weight loss of >5% was also associated with a lowered risk of HS with intermediate or high probability of advanced fibrosis. In mediation analyses, associations remained significant, although adjustment for metabolic risk factors was attenuating. Discussion: Clinically relevant weight loss was associated with a reduced risk of developing nonalcoholic fatty liver disease with or without intermediate or high probability of advanced fibrosis in metabolically healthy overweight or obese individuals.
Body Mass Index, Metabolically Healthy Obesity, Nonalcoholic Fatty Liver Disease, Obesity, Overweight
e583-e599
Cho, In Young
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Chang, Yoosoo
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Sung, Eunju
92c0edcb-eac5-49b5-860a-0a3447ca223f
Kang, Jae-Heon
e1138227-23eb-4d80-8fb6-e5610414349d
Shin, Hocheol
a4e52a27-c212-4e8c-b81e-4d0526a9e29e
Wild, Sarah H.
f1bee83c-b7f7-4ecb-923f-a1587ce818bd
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
587220a6-ec9a-4472-9c11-d8dcac20a975
28 April 2021
Cho, In Young
808b1645-7c73-4551-a506-7ef7f7db7040
Chang, Yoosoo
2cf83401-3c75-48ee-b85f-31ca5d627195
Sung, Eunju
92c0edcb-eac5-49b5-860a-0a3447ca223f
Kang, Jae-Heon
e1138227-23eb-4d80-8fb6-e5610414349d
Shin, Hocheol
a4e52a27-c212-4e8c-b81e-4d0526a9e29e
Wild, Sarah H.
f1bee83c-b7f7-4ecb-923f-a1587ce818bd
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
587220a6-ec9a-4472-9c11-d8dcac20a975
Cho, In Young, Chang, Yoosoo, Sung, Eunju, Kang, Jae-Heon, Shin, Hocheol, Wild, Sarah H., Byrne, Christopher and Ryu, Seungho
(2021)
Weight change and the development of non-alcoholic fatty liver disease in metabolically healthy overweight individuals.
Clinical Gastroenterology and Hepatology, 20 (3), .
(doi:10.1016/j.cgh.2021.04.037).
Abstract
Introduction: The study sought to investigate the effect of weight change on hepatic steatosis (HS) incidence with or without liver fibrosis in metabolically healthy overweight or obese individuals. Methods: A cohort of 14,779 metabolically healthy men and women who were overweight or obese (body mass index ≥23 kg/m
2) and free from HS and an intermediate or high probability of fibrosis at baseline were followed for a median of 5.2 years. Metabolic health was defined as freedom from the components of metabolic syndrome and a homeostatic model assessment of insulin resistance <2.5. Weight changes were calculated as differences from baseline at the next subsequent visit. The outcome was HS incidence, with or without liver fibrosis, as assessed by liver ultrasound and 2 noninvasive fibrosis scores. Results: During 76,794.6 person-years of follow-up, 3539 cases of HS incidence were identified. The multivariable adjusted hazard ratios (95% confidence intervals) for HS incidence by weight change group, <–5.0%, –5.0%–1.0%, 1.0%–5.0%, and >5.0%, relative to the no weight change group (–0.9% to 0.9%) were 0.52 (0.44–0.60), 0.83 (0.75–0.92), 1.21 (1.10–1.33), and 1.51 (1.36–1.69), respectively. Clinically relevant weight loss of >5% was also associated with a lowered risk of HS with intermediate or high probability of advanced fibrosis. In mediation analyses, associations remained significant, although adjustment for metabolic risk factors was attenuating. Discussion: Clinically relevant weight loss was associated with a reduced risk of developing nonalcoholic fatty liver disease with or without intermediate or high probability of advanced fibrosis in metabolically healthy overweight or obese individuals.
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Accepted/In Press date: 21 April 2021
e-pub ahead of print date: 28 April 2021
Published date: 28 April 2021
Additional Information:
Funding Information:
Funding This work was supported by SKKU Excellence in Research Award Research Fund, Sungkyunkwan University , 2020 and by the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2017R1A2B2008401). Christopher D. Byrne is supported in part by the Southampton National Institute of Health Research Biomedical Research Centre (IS-BRC-20004), United Kingdom.
Publisher Copyright:
© 2021 AGA Institute
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Body Mass Index, Metabolically Healthy Obesity, Nonalcoholic Fatty Liver Disease, Obesity, Overweight
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Local EPrints ID: 449970
URI: http://eprints.soton.ac.uk/id/eprint/449970
PURE UUID: a6526678-a041-43df-9245-45d17482eea0
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Date deposited: 01 Jul 2021 16:30
Last modified: 17 Mar 2024 06:31
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Contributors
Author:
In Young Cho
Author:
Yoosoo Chang
Author:
Eunju Sung
Author:
Jae-Heon Kang
Author:
Hocheol Shin
Author:
Sarah H. Wild
Author:
Seungho Ryu
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