Association between weight change, waist circumference change, and the risk of nonalcoholic fatty liver disease in individuals with metabolically healthy overweight or obesity and metabolically unhealthy overweight or obesity

Sailimai Man; Yuhan Deng; Yuan Ma; Xiaochen Yang; Xiaona Wang; Jingzhu Fu; Canqing Yu; Jun Lv; Jing Du; Bo Wang; Liming Li

doi:10.1016/j.orcp.2024.02.007

Association between weight change, waist circumference change, and the risk of nonalcoholic fatty liver disease in individuals with metabolically healthy overweight or obesity and metabolically unhealthy overweight or obesity

Obes Res Clin Pract. 2024 Mar-Apr;18(2):109-117. doi: 10.1016/j.orcp.2024.02.007. Epub 2024 Mar 4.

Authors

Sailimai Man¹, Yuhan Deng², Yuan Ma³, Xiaochen Yang⁴, Xiaona Wang⁵, Jingzhu Fu⁶, Canqing Yu⁷, Jun Lv⁷, Jing Du⁸, Bo Wang⁹, Liming Li¹⁰

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Meinian Institute of Health, Beijing 100083, China; Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China.
² Meinian Institute of Health, Beijing 100083, China; Chongqing Research Institute of Big Data, Peking University, Chongqing 400000, China.
³ Meinian Institute of Health, Beijing 100083, China; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
⁴ Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China.
⁵ Beijing MJ Health Check-up Center, Beijing 100000, China.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China.
⁷ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China.
⁸ Beijing Centre for Disease Prevention and Control, Beijing 100013, China. Electronic address: dujing100@foxmail.com.
⁹ Meinian Institute of Health, Beijing 100083, China; Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China. Electronic address: paul@meinianresearch.com.
¹⁰ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China. Electronic address: lmlee@bjmu.edu.cn.

PMID: 38443283
DOI: 10.1016/j.orcp.2024.02.007

Abstract

Background: This study aimed to explore and compare the effect of weight change, and waist circumference (WC) change, on the risk of nonalcoholic fatty liver disease (NAFLD) in individuals with metabolically healthy overweight or obesity (MHOW/O) and metabolically unhealthy overweight or obesity (MUOW/O) in a health check-up cohort in China.

Methods: 5625 adults with overweight or obesity, and free from NAFLD at baseline were included. Metabolically healthy was defined as not having any components of metabolic syndrome. Weight/WC changes were calculated as the relative difference between the first and second visits of check-up. NAFLD was assessed based on abdominal ultrasound.

Results: During a median follow-up of 2.1 (IQR: 1.1-4.3) years, 1849 participants developed NAFLD. In MHOW/O participants, the multivariable adjusted HRs (95 % CIs) for NAFLD in weight change ≤ -5.0 %, and - 4.9-- 1.0 % were 0.36 (0.23-0.59), 0.59 (0.43-0.80), respectively, compared to the weight stable group (-0.9% to 0.9 %). The corresponding HRs (95 % CIs) for the association between WC change (≤ 6.0 %, - 5.9 to -3.0 %) and NAFLD in MHOW/O participants were 0.41 (0.27-0.62), and 0.74 (0.54-1.01), respectively, compared to the WC stable group (-2.9-2.9 %). Similar patterns were observed in MUOW/O participants. A more marked gradient of cumulative incidence of NAFLD across weight/WC change categories was observed in MHOW/O than in MUOW/O individuals.

Conclusions: A more evident association between weight/WC loss and risk of NAFLD was observed in MHOW/O than in MUOW/O individuals. Our findings indicate the practical significance of encouraging all individuals with overweight and obesity to achieve a clinically relevant level of weight/WC loss to prevent NAFLD, even among metabolic healthy groups.

Keywords: Fatty liver disease; Metabolically healthy obesity; Risk factors; Weight gain; Weight loss.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China / epidemiology
Female
Humans
Male
Metabolic Syndrome* / epidemiology
Metabolic Syndrome* / etiology
Middle Aged
Non-alcoholic Fatty Liver Disease* / epidemiology
Non-alcoholic Fatty Liver Disease* / etiology
Obesity* / complications
Obesity* / epidemiology
Overweight* / complications
Risk Factors
Waist Circumference*
Weight Gain / physiology
Weight Loss