Format

Send to

Choose Destination
See comment in PubMed Commons below
Liver Int. 2017 Sep 29. doi: 10.1111/liv.13603. [Epub ahead of print]

Body mass index trajectories in young adulthood predict non-alcoholic fatty liver disease in middle age: The CARDIA cohort study.

Author information

1
Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
2
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
3
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
4
Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
5
Department of Radiology, Vanderbilt University, Nashville, TN, USA.
6
Division of Gastroenterology, Department of Pediatrics, Emory University, Atlanta, GA, USA.
7
Division of Gastroenterology, University of Michigan, Ann Arbor, MI, USA.
8
Division of Gastroenterology & Hepatology, University of California at San Francisco, San Francisco, CA, USA.

Abstract

BACKGROUND & AIMS:

Non-alcoholic fatty liver disease is an epidemic. Identifying modifiable risk factors for non-alcoholic fatty liver disease development is essential to design effective prevention programmes. We tested whether 25-year patterns of body mass index change are associated with midlife non-alcoholic fatty liver disease.

METHODS:

In all, 4423 participants from Coronary Artery Risk Development in Young Adults, a prospective population-based biracial cohort (age 18-30), underwent body mass index measurement at baseline (1985-1986) and 3 or more times over 25 years. At Year 25, 3115 had liver fat assessed by non-contrast computed tomography. Non-alcoholic fatty liver disease was defined as liver attenuation ≤40 Hounsfield Units after exclusions. Latent mixture modelling identified 25-year trajectories in body mass index per cent change (%Δ) from baseline.

RESULTS:

We identified four distinct trajectories of BMI%Δ: stable (26.2% of cohort, 25-year BMI %Δ = 3.1%), moderate increase (46.0%, BMI%Δ = 21.7%), high increase (20.9%, BMI%Δ = 41.9%) and extreme increase (6.9%, BMI%Δ = 65.9%). Y25 non-alcoholic fatty liver disease prevalence was higher in groups with greater BMI %Δ: 4.1%, 9.3%, 13.0%, and 17.6%, respectively (P-trend <.0001). In multivariable analyses, participants with increasing BMI%Δ had increasingly greater odds of non-alcoholic fatty liver disease compared to the stable group: OR: 3.35 (95% CI: 2.07-5.42), 7.80 (4.60-13.23) and 12.68 (6.68-24.09) for moderate, high and extreme body mass index increase, respectively. Associations were only moderately attenuated when adjusted for baseline or Y25 body mass index.

CONCLUSIONS:

Trajectories of weight gain during young adulthood are associated with greater non-alcoholic fatty liver disease prevalence in midlife independent of metabolic covariates and baseline or concurrent body mass index highlighting the importance of weight maintenance throughout adulthood as a target for primary non-alcoholic fatty liver disease prevention.

KEYWORDS:

NAFLD; NASH; obesity; prevention

PMID:
28963767
DOI:
10.1111/liv.13603
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center