Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, the Republic of Korea; Department of Medicine, Hanyang University Graduate School of Medicine, Seoul 04763, the Republic of Korea.
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 03277, the Republic of Korea.
Obes Res Clin Pract. 2023 Sep-Oct;17(5):398-404. doi: 10.1016/j.orcp.2023.09.005. Epub 2023 Sep 12.
Waist circumference (WC) is linked to non-alcoholic fatty liver disease (NAFLD) incidence. However, the impact of longitudinal WC changes on NAFLD remains unclear. We investigated WC trajectories and NAFLD incidence in a large population-based cohort.
We analyzed data from 2666 participants without NAFLD, who underwent biennial check-ups for 16 years, divided into a 6-year exposure period and a 10-year event accrual period. Participants were classified into increasing and decreasing WC trajectory groups during the median 5.9-year exposure period by group-based trajectory modeling. Multiple Cox proportional hazard regression analysis estimated the hazard ratio (HR) and 95 % confidence interval (CI) for incident NAFLD.
During the median 9.7-year event accrual period, 799 participants developed NAFLD. The increasing WC trajectory group had a higher NAFLD risk than the decreasing group, with an HR of 1.20 (95 % CI: 1.02-1.42). After adjusting for confounders, the adjusted-HR was 1.28 (95 % CI: 1.07-1.53). Subgroup analyses revealed significant findings for groups, regardless of abdominal obesity status.
An increasing WC trend was associated with a higher NAFLD risk, independent of abdominal obesity status. Monitoring WC changes may facilitate early detection of NAFLD risk groups and promote lifestyle modifications to prevent NAFLD onset.
腰围(WC)与非酒精性脂肪性肝病(NAFLD)的发生有关。然而,WC 纵向变化对 NAFLD 的影响尚不清楚。我们在一个大型基于人群的队列中研究了 WC 轨迹和 NAFLD 的发病率。
我们分析了 2666 名无 NAFLD 的参与者的数据,这些参与者在 16 年内每两年接受一次检查,分为 6 年暴露期和 10 年事件累积期。在中位数为 5.9 年的暴露期内,通过基于群组的轨迹建模将参与者分为 WC 轨迹增加和减少的轨迹组。多 Cox 比例风险回归分析估计了发生 NAFLD 的风险比(HR)和 95%置信区间(CI)。
在中位数为 9.7 年的事件累积期内,799 名参与者发生了 NAFLD。与 WC 减少的轨迹组相比,WC 增加的轨迹组发生 NAFLD 的风险更高,HR 为 1.20(95%CI:1.02-1.42)。调整混杂因素后,调整后的 HR 为 1.28(95%CI:1.07-1.53)。亚组分析显示,无论腹部肥胖状况如何,各分组均有显著发现。
WC 增加的趋势与更高的 NAFLD 风险相关,与腹部肥胖状况无关。监测 WC 变化可能有助于早期发现 NAFLD 高危人群,并促进生活方式改变以预防 NAFLD 的发生。