Department of Community and Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
J Gastroenterol Hepatol. 2021 Oct;36(10):2903-2910. doi: 10.1111/jgh.15544. Epub 2021 May 31.
Obesity and metabolic conditions may be related to non-alcoholic fatty liver disease (NAFLD). The study assesses the risk of NAFLD according to obesity and metabolic health status in a community-based population.
A total of 1651 subjects were recruited from the community. Individuals were categorized into four groups according to obesity status (defined as a body mass index ≥ 25 kg/m ) and metabolically healthy status: metabolically healthy nonobesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy nonobesity (MUHNO), and metabolically unhealthy obesity (MUHO). NAFLD was diagnosed based on a semiquantitative ultrasonography measurement. Visceral fat was assessed through bioelectrical impedance analysis and is shown by tertile (T1, T2, and T3). A proportional odds model was used to assess the cumulative risk of NAFLD.
The NAFLD prevalence was 26.7%, 62.8%, 47.0%, and 76.7% in subjects with MHNO, MHO, MUHNO, and MUHO, respectively (P < 0.0001). After adjustment for age, sex, exercise habits, alcohol consumption, cigarette smoking, and visceral fat, the odds ratios for more severe NAFLD were 2.44 (95% confidence interval [CI]: 1.64-3.65), 2.75 (95% CI: 1.91-3.94), and 7.41 (95% CI: 4.94-11.12) in the MHO, MUHNO, and MUHO groups, respectively, compared with the MHNO group. In addition, the odds ratios for more severe NAFLD significantly increased with the increase in visceral fat level (T2 vs T1: 3.83, 95% CI: 2.65-5.53; T3 vs T1: 9.17, 95% CI: 5.33-15.79).
Both obesity and metabolically unhealthy status were associated with a higher risk of NAFLD independent of visceral fat level.
肥胖和代谢状况可能与非酒精性脂肪性肝病（NAFLD）有关。本研究评估了社区人群中根据肥胖和代谢健康状况发生 NAFLD 的风险。
共招募了 1651 名来自社区的受试者。根据肥胖状况（定义为体重指数≥25kg/m²）和代谢健康状况，将个体分为四组：代谢健康非肥胖（MHNO）、代谢健康肥胖（MHO）、代谢不健康非肥胖（MUHNO）和代谢不健康肥胖（MUHO）。NAFLD 基于半定量超声测量诊断。通过生物电阻抗分析评估内脏脂肪，并显示为三分位（T1、T2 和 T3）。使用比例优势模型评估 NAFLD 的累积风险。
MHNO、MHO、MUHNO 和 MUHO 组的 NAFLD 患病率分别为 26.7%、62.8%、47.0%和 76.7%（P<0.0001）。在校正年龄、性别、运动习惯、饮酒、吸烟和内脏脂肪后，MHO、MUHNO 和 MUHO 组发生更严重 NAFLD 的比值比分别为 2.44（95%可信区间[CI]：1.64-3.65）、2.75（95% CI：1.91-3.94）和 7.41（95% CI：4.94-11.12），与 MHNO 组相比。此外，随着内脏脂肪水平的增加，发生更严重 NAFLD 的比值比显著增加（T2 与 T1：3.83，95% CI：2.65-5.53；T3 与 T1：9.17，95% CI：5.33-15.79）。
肥胖和代谢不健康状态均与 NAFLD 风险增加相关，与内脏脂肪水平无关。
