Paris-Saclay University, Paris, France.
Department of Diabetes and Endocrinology, Sud-Francilien Hospital, Corbeil-Essonnes, France.
Hepatology. 2022 Nov;76(5):1438-1451. doi: 10.1002/hep.32540. Epub 2022 Jun 8.
The association between birth weight (BW) and metabolic outcomes has been described since the 1980s but NAFLD has been rarely studied. This study aimed to investigate the association between BW and NAFLD occurrence in adult subjects.
The study population consisted of participants from the French nationwide Constances cohort from 2012 to 2019. Participants with a history of chronic viral hepatitis or excessive alcohol consumption were excluded. Noninvasive diagnosis of NAFLD and fibrosis was performed using a combination of the Fatty Liver Index (FLI) and the Forns Index. The relationship between BW and NAFLD was analyzed with a sex-stratified logistic regression model adjusted for sociodemographic parameters, lifestyle, and birth term, whereas liver fibrosis was analyzed with a sex-stratified linear regression model. In total, 55,034 individuals with reliable BW were included (43% men, mean age: 38 years). NAFLD (FLI ≥ 60) was present in 5530 individuals (10%). Multivariate logistic regression showed a significant U-shaped relationship between BW and NAFLD, with no significant interaction with sex. A significant and slightly decreasing association was found between BW and Forns Index (β = -0.05; p = 0.04). Premature birth (OR, 1.23; 95% CI, 1.03-1.48 for birth between 33 and 37 weeks versus ≥ 37 weeks) was associated with NAFLD, with a significant direct effect of premature birth, and without an indirect effect of low BW in mediation analysis. Forns Index was not significantly higher in participants with preterm birth compared to full-term birth.
This large prospective adult-based cohort confirms the relationship between BW and NAFLD occurrence.
自 20 世纪 80 年代以来，人们就已经描述了出生体重（BW）与代谢结果之间的关系，但很少有研究探讨非酒精性脂肪性肝病（NAFLD）。本研究旨在调查成年人群中 BW 与 NAFLD 发生之间的关系。
研究人群来自法国全国 Constances 队列 2012 年至 2019 年的参与者。排除有慢性病毒性肝炎或过量饮酒史的参与者。使用 Fatty Liver Index（FLI）和 Forns Index 的组合对 NAFLD 和纤维化进行非侵入性诊断。使用按性别分层的逻辑回归模型调整社会人口统计学参数、生活方式和出生时龄后，分析 BW 与 NAFLD 之间的关系，而使用按性别分层的线性回归模型分析肝纤维化。共纳入 55034 名具有可靠 BW 的个体（43%为男性，平均年龄为 38 岁）。5530 名个体（10%）存在 NAFLD（FLI≥60）。多变量逻辑回归显示，BW 与 NAFLD 之间存在显著的 U 形关系，与性别无显著交互作用。BW 与 Forns Index 之间存在显著且略微下降的关联（β=-0.05；p=0.04）。早产（出生时龄在 33 周至 37 周与≥37 周之间的 OR，1.23；95%CI，1.03-1.48）与 NAFLD 相关，早产具有显著的直接效应，中介分析中不存在 BW 低导致的间接效应。与足月出生相比，早产参与者的 Forns Index 并不显著更高。
这项基于大型前瞻性成人的队列研究证实了 BW 与 NAFLD 发生之间的关系。
