Hashimoto Yoshitaka, Hamaguchi Masahide, Fukuda Takuya, Nakamura Naoto, Ohbora Akihiro, Kojima Takao, Fukui Michiaki
aDepartment of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine bDepartment of Diabetology, Kameoka Municipal Hospital, Kyoto cDepartment of Gastroenterology, Murakami Memorial Hospital, Asahi University, Gifu, Japan.
Eur J Gastroenterol Hepatol. 2016 Oct;28(10):1188-93. doi: 10.1097/MEG.0000000000000682.
Most physicians might consider that fatty liver would develop along with increasing body weight; however, an association between BMI history and incident fatty liver has not been clarified as yet.
We carried out a population-based cohort study that included 4427 healthy Japanese individuals who received yearly health-checkup programs over a decade. Fatty liver was diagnosed using ultrasonography.
During the observational period, 38.7% (case/N=1002/2588) of men and 17.3% (319/1847) of women were diagnosed with fatty liver. Among these, only 18.9% (189 of 1002 participants) of men and 18.5% (59 of 319) of women developed fatty liver when they reached the lifetime maximum BMI. Adjusted odds ratio of the difference between lifetime maximum BMI and BMI at age 20 years (ΔBMImax-20 years) for incident fatty liver was 1.33 [95% confidence interval (CI) 1.28-1.39, P<0.001] in men or 1.40 (95% CI 1.33-1.49, P<0.001) in women. According to receiver operator characteristic (ROC) analysis, the optimal cut-off points of ΔBMImax-20 years for incident fatty liver were 4.82 kg/m [area under ROC curve 0.70 (95% CI 0.68-0.72), P<0.001] in men and 4.11 kg/m [area under ROC curve 0.76 (95% CI 0.73-0.79), P<0.001] in women.
The ΔBMImax-20 years was associated with an increased risk of incident fatty liver. In addition, more patients developed fatty liver not at the maximum point of BMI history, but after that. Therefore, it is useful to check ΔBMImax-20 years and to continue observing the individuals for detection of fatty liver.
大多数医生可能认为脂肪肝会随着体重增加而发展；然而，BMI历史与新发脂肪肝之间的关联尚未明确。
我们开展了一项基于人群的队列研究，纳入了4427名健康的日本个体，他们在十年间接受了年度健康检查项目。通过超声检查诊断脂肪肝。
在观察期内，38.7%（病例数/总数=1002/2588）的男性和17.3%（319/1847）的女性被诊断为脂肪肝。其中，只有18.9%（1002名参与者中的189名）的男性和18.5%（319名中的59名）的女性在达到终身最大BMI时患上脂肪肝。男性新发脂肪肝的终身最大BMI与20岁时BMI之差（ΔBMImax-20岁）的调整优势比为1.33[95%置信区间（CI）1.28-1.39，P<0.001]，女性为1.40（95%CI 1.33-1.49，P<0.001）。根据受试者工作特征（ROC）分析，男性新发脂肪肝的ΔBMImax-20岁的最佳截断点为4.82kg/m²[ROC曲线下面积0.70（95%CI 0.68-0.72），P<0.001]，女性为4.11kg/m²[ROC曲线下面积0.76（95%CI 0.73-0.79），P<0.001]。
ΔBMImax-20岁与新发脂肪肝风险增加相关。此外，更多患者并非在BMI历史最高点时患上脂肪肝，而是在此之后。因此，检查ΔBMImax-20岁并持续观察个体以检测脂肪肝是有用的。
