Journal article
Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease
The American journal of gastroenterology, v 111(8), pp 1133-1140
01 Aug 2016
PMID: 27185080
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVES: The risk of nonalcoholic fatty liver disease (NAFLD) among obese individuals without obesity-related metabolic abnormalities, a condition referred to as metabolically healthy obese (MHO), is largely unexplored. Therefore, we examined the association between body mass index (BMI) categories and the development of NAFLD in a large cohort of metabolically healthy men and women.
METHODS: A cohort study was conducted in 77,425 men and women free of NAFLD and metabolic abnormalities at baseline, who were followed-up annually or biennially for an average of 4.5 years. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance <2.5. The presence of fatty liver was determined using ultrasound.
RESULTS: During 348,193.5 person-years of follow-up, 10,340 participants developed NAFLD (incidence rate, 29.7 per 1,000 person-years). The multivariable adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing overweight and obese with normal-weight participants were 2.15 (2.06-2.26) and 3.55 (3.37-3.74), respectively. In detailed dose-response analyses, increasing baseline BMI showed a strong and approximately linear relationship with the incidence of NAFLD, with no threshold at no risk. This association was present in both men and women, although it was stronger in women (P for interaction <0.001), and it was evident in all clinically relevant subgroups evaluated, including participants with low inflammation status.
CONCLUSIONS: In a large cohort of strictly defined metabolically healthy men and women, overweight and obesity were strongly and progressively associated with an increased incidence of NAFLD, suggesting that the obese phenotype per se, regardless of metabolic abnormalities, can increase the risk of NAFLD.
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Details
- Title
- Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease
- Creators
- Yoosoo Chang - Kangbuk Samsung HospitalHyun-Suk Jung - Kangbuk Samsung HospitalJuhee Cho - Sungkyunkwan UniversityYiyi Zhang - Johns Hopkins UniversityKyung Eun Yun - Kangbuk Samsung HospitalMariana Lazo - Johns Hopkins UniversityRoberto Pastor-Barriuso - Centro de Investigación Biomédica en Red de Epidemiología y Salud PúblicaJiin Ahn - Kangbuk Samsung HospitalChan-Won Kim - Kangbuk Samsung HospitalSanjay Rampal - Johns Hopkins UniversityMiguel Cainzos-Achirica - Johns Hopkins UniversityDi Zhao - Johns Hopkins UniversityEun Cheol Chung - Sungkyunkwan UniversityHocheol Shin - Kangbuk Samsung HospitalEliseo Guallar - Johns Hopkins UniversitySeungho Ryu - Kangbuk Samsung Hospital
- Publication Details
- The American journal of gastroenterology, v 111(8), pp 1133-1140
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000384720000015
- Scopus ID
- 2-s2.0-84982994828
- Other Identifier
- 991020550499004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Gastroenterology & Hepatology