Kimura Takeshi, Deshpande Gautam A, Urayama Kevin Y, Masuda Katsunori, Fukui Tsuguya, Matsuyama Yutaka
Center for Preventive Medicine, St. Luke's International University, Tokyo, Japan; Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan.
J Gastroenterol Hepatol. 2015 May;30(5):909-17. doi: 10.1111/jgh.12861.
Interventions for lifestyle diseases including non-alcoholic fatty liver disease (NAFLD) have focused on overweight and obese populations. The impact of adult weight gain on NAFLD development among normal weight individuals remains unclear.
In this cross-sectional study, we collected data from participants presenting to a health check-up program. Ultrasound-diagnosed NAFLD prevalence was examined over 1-kg increments of weight change since age 20. Relative risks were calculated in men and women stratified by current weight (normal, overweight, and obese). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for potential confounders.
Among 21 496 participants, 3498 cases of NAFLD (16.3%) were observed. Prevalence of NAFLD increased with weight gain since age 20; among the 10.1-11.0 kg weight gain group, 41.6% of men and 24.8% of women had NAFLD. Multivariate analysis by quartiles showed that weight change was significantly associated with NAFLD risk in men and women. Risk of NAFLD associated with weight change (10-kg increments) was significantly higher in normal weight individuals (men: OR 7.53, 95% CI: 4.99-11.36, women: OR 12.20, 95% CI: 7.45-19.98) than overweight (men: OR 1.61, 95% CI: 0.91-2.85, women: OR 2.90, 95% CI: 0.99-8.54) and obese (men: OR 4.0, 95% CI: 2.97-5.39, women: OR 2.68, 95% CI: 2.00-3.60).
NAFLD is robustly associated with weight change since age 20. This effect appears particularly strong in individuals at normal weight, suggesting an important role for early and longitudinal weight monitoring, even among healthy individuals at normal weight.
包括非酒精性脂肪性肝病（NAFLD）在内的生活方式疾病干预措施主要集中在超重和肥胖人群。成年后体重增加对正常体重个体发生NAFLD的影响仍不明确。
在这项横断面研究中，我们收集了参加健康检查项目的参与者的数据。自20岁起，以体重变化每增加1千克为增量，检查超声诊断的NAFLD患病率。按当前体重（正常、超重和肥胖）对男性和女性进行分层，计算相对风险。采用逻辑回归估计比值比（OR）和95%置信区间（CI），并对潜在混杂因素进行校正。
在21496名参与者中，观察到3498例NAFLD（16.3%）。自20岁起，NAFLD患病率随体重增加而升高；在体重增加10.1 - 11.0千克组中，41.6%的男性和24.8%的女性患有NAFLD。按四分位数进行的多变量分析表明，体重变化与男性和女性的NAFLD风险显著相关。与体重变化（增加10千克）相关的NAFLD风险在正常体重个体中（男性：OR 7.53，95% CI：4.99 - 11.36；女性：OR 12.20，95% CI：7.45 - 19.98）显著高于超重个体（男性：OR 1.61，95% CI：0.91 - 2.85；女性：OR 2.90，95% CI：0.99 - 8.54）和肥胖个体（男性：OR 4.0，95% CI：2.97 - 5.39；女性：OR 2.68，95% CI：2.00 - 3.60）。
NAFLD与自20岁起的体重变化密切相关。这种影响在正常体重个体中尤为明显，这表明即使在体重正常的健康个体中，早期和长期的体重监测也具有重要作用。
