Sogabe Masahiro, Okahis Toshiya, Kagawa Miwako, Sei Motoko, Ueda Hiroyuki, Yokoyama Reiko, Kagemoto Kaizo, Tanaka Hironori, Kida Yoshifumi, Nakamura Fumika, Tomonari Tetsu, Okamoto Koichi, Miyamoto Hiroshi, Sato Yasushi, Nakasono Masahiko, Takayama Tetsuji
Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan; Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo City, Ehime, 799-0193, Japan.
Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan; Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, 2233 Kawanoe-cho, Shikokuchuo City, Ehime, 799-0193, Japan.
Diabetes Metab Syndr. 2024 May;18(5):103036. doi: 10.1016/j.dsx.2024.103036. Epub 2024 May 8.
Although body weight reduction is recommended to ameliorate nonalcoholic fatty liver disease, the effects of body mass index (BMI) and waist circumference (WC) variability on newly achieved remission of metabolic dysfunction-associated fatty liver disease (MAFLD) remain unclear. We aimed to investigate the longitudinal association between BMI and WC variabilities and newly achieved MAFLD remission in both sexes.
Among 26,952 patients, 1823 with MAFLD diagnosed by ultrasonography and with >2 health checkups over >2 years from April 2014 to March 2021 were included in this observational cohort study. A generalized estimation equation model analyzed the association between BMI and WC and newly achieved MAFLD remission according to repeated measures at baseline and the most recent stage.
Rates of MAFLD remission in male and female patients were 7.4 % and 6.0 %, respectively. Regarding decreased BMI variability, newly achieved MAFLD remission prevalence among the subgroups differed significantly between sexes (p < 0.001). In male patients, a decrease in BMI variability of ≥1.5 kg/m and WC variability of ≥4.2 cm had adjusted odds ratios (ORs) of 5.215 and 2.820, respectively, for newly achieved MAFLD remission. Among female patients, regular exercise and breakfast consumption were accelerating factors for newly achieved MAFLD remission. Non-invasive liver fibrosis scores significantly differed between MAFLD and newly achieved MAFLD remission, including in the subgroups (p < 0.01 and p < 0.001, respectively).
Reducing BMI and WC variabilities in male patients and improving lifestyle habits in female patients may accelerate MAFLD remission.
尽管建议减轻体重以改善非酒精性脂肪性肝病，但体重指数（BMI）和腰围（WC）变异性对新实现的代谢功能障碍相关脂肪性肝病（MAFLD）缓解的影响仍不清楚。我们旨在研究BMI和WC变异性与男女新实现的MAFLD缓解之间的纵向关联。
在26952例患者中，本观察性队列研究纳入了1823例经超声诊断为MAFLD且在2014年4月至2021年3月期间进行了超过2年的2次以上健康检查的患者。广义估计方程模型根据基线和最近阶段的重复测量分析了BMI和WC与新实现的MAFLD缓解之间的关联。
男性和女性患者的MAFLD缓解率分别为7.4%和6.0%。关于BMI变异性降低，各亚组中新实现的MAFLD缓解患病率在性别之间存在显著差异（p<0.001）。在男性患者中，BMI变异性降低≥1.5kg/m和WC变异性降低≥4.2cm时，新实现MAFLD缓解的调整比值比（OR）分别为5.215和2.820。在女性患者中，规律运动和吃早餐是新实现MAFLD缓解的促进因素。MAFLD与新实现的MAFLD缓解之间的非侵入性肝纤维化评分存在显著差异，包括在亚组中（分别为p<0.01和p<0.001）。
降低男性患者的BMI和WC变异性以及改善女性患者的生活习惯可能会加速MAFLD缓解。
