Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease

被引：158

作者：

Chang, Yoosoo ^{[1
,2
,3
]}

Jung, Hyun-Suk ^{[1
]}

Cho, Juhee ^{[1
,3
,4
]}

Zhang, Yiyi ^{[4
,5
,6
]}

Yun, Kyung Eun ^{[1
]}

Lazo, Mariana ^{[4
,5
,6
]}

Pastor-Barriuso, Roberto ^{[7
,8
]}

Ahn, Jiin ^{[1
]}

Kim, Chan-Won ^{[1
]}

Rampal, Sanjay ^{[4
,6
,9
]}

Cainzos-Achirica, Miguel ^{[4
,6
,10
]}

Zhao, Di ^{[4
,5
,6
]}

Chung, Eun Cheol ^{[11
]}

Shin, Hocheol ^{[12
]}

Guallar, Eliseo ^{[4
,5
,6
]}

Ryu, Seungho ^{[1
,2
,3
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Ctr Cohort Studies,Total Healthcare Ctr, Seoul, South Korea

[2] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Occupat & Environm Med, Seoul, South Korea

[3] Sungkyunkwan Univ, Samsung Adv Inst Hlth Sci & Technol, Dept Hlth Sci & Technol, Seoul, South Korea

[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[5] Johns Hopkins Sch Publ Hlth, Dept Med, Baltimore, MD USA

[6] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Welch Ctr Prevent Epidemiol & Clin Res, 2024 E Monument St,Room 2-645, Baltimore, MD 21205 USA

[7] Carlos III Inst Hlth, Natl Ctr Epidemiol, Madrid, Spain

[8] Consortium Biomed Res Epidemiol & Publ Hlth CIBER, Madrid, Spain

[9] Univ Malaya, Fac Med, Julius Ctr, Dept Social & Prevent Med, Kuala Lumpur, Malaysia

[10] Johns Hopkins Med Inst, Dept Cardiol, Ciccarone Ctr Prevent Heart Dis, Baltimore, MD 21205 USA

[11] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Radiol, Seoul, South Korea

[12] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Family Med, Seoul, South Korea

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2016年 / 111卷 / 08期

关键词：

RISK-FACTORS; CARDIOVASCULAR-DISEASE; ALL-CAUSE; ADIPOSE-TISSUE; OVERWEIGHT; TIME; STEATOHEPATITIS; ABNORMALITIES; ASSOCIATION; PREVALENCE;

D O I：

10.1038/ajg.2016.178

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

OBJECTIVES: The risk of nonalcoholic fatty liver disease (NAFLD) among obese individuals without obesity-related metabolic abnormalities, a condition referred to as metabolically healthy obese (MHO), is largely unexplored. Therefore, we examined the association between body mass index (BMI) categories and the development of NAFLD in a large cohort of metabolically healthy men and women. METHODS: A cohort study was conducted in 77,425 men and women free of NAFLD and metabolic abnormalities at baseline, who were followed-up annually or biennially for an average of 4.5 years. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance <2.5. The presence of fatty liver was determined using ultrasound. RESULTS: During 348,193.5 person-years of follow-up, 10,340 participants developed NAFLD (incidence rate, 29.7 per 1,000 person-years). The multivariable adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing overweight and obese with normal-weight participants were 2.15 (2.06-2.26) and 3.55 (3.37-3.74), respectively. In detailed dose-response analyses, increasing baseline BMI showed a strong and approximately linear relationship with the incidence of NAFLD, with no threshold at no risk. This association was present in both men and women, although it was stronger in women (P for interaction <0.001), and it was evident in all clinically relevant subgroups evaluated, including participants with low inflammation status. CONCLUSIONS: In a large cohort of strictly defined metabolically healthy men and women, overweight and obesity were strongly and progressively associated with an increased incidence of NAFLD, suggesting that the obese phenotype per se, regardless of metabolic abnormalities, can increase the risk of NAFLD.

引用

页码：1133 / 1140

页数：8