Joint associations of metabolically healthy abdominal obesity and non-alcoholic fatty liver disease with prediabetes and diabetes in Chinese adults

IntroductionWe aimed to evaluate the joint associations of metabolically healthy abdominal obesity (MHAO) with non-alcoholic fatty liver disease (NAFLD) on risks of diabetes and prediabetes.Research design and methodsBaseline information of 1318 adults with abdominal obesity (waist circumference ≥90 cm for men and 80 cm for women) from an ongoing cohort study in Xiamen, China were analyzed. Metabolic health was identified as none of the criteria of metabolism syndrome, except for obesity, was met.ResultsMHAO and metabolically unhealthy abdominal obesity (MUAO) were identified on 173 (13.1%) and 1145 (86.9%) subjects. NAFLD was further diagnosed on 60 (34.7%) in MHAO and 721 (63.0%) in MUAO groups (p<0.001). Both MUAO (vs MHAO) and NAFLD (vs non-NAFLD) were independently associated with increased risks of diabetes as well as prediabetes plus diabetes, with the adjusted ORs (95% CIs) of 9.40 (3.38 to 26.14) and 2.02 (1.47 to 2.77), respectively. Compared with MHAO and non-NAFLD, MHAO and NAFLD showed significantly increased risks of prediabetes plus diabetes with the adjusted ORs (95% CIs) of 2.87 (1.32 to 6.27, p=0.008). And there were significantly positive trends between increasing categories jointly by MHAO and NAFLD (from MHAO and non-NAFLD, MHAO and NAFLD, MUAO and non-NAFLD to MUAO and NAFLD) with risks of diabetes and prediabetes plus diabetes (both trend tests: p<0.001).ConclusionsAbout 35% of subjects with MHAO accompanied by NAFLD showed excessive risk of prediabetes plus diabetes compared with MHAO and non-NAFLD. Thus, NAFLD should be screened and intervened even for those subjects with metabolically healthy obesity (MHO) and should be considered as one additional criterion when defining and diagnosing MHO.

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Weight Change and the Development of Non-Alcoholic Fatty Liver Disease in Metabolically Healthy Overweight Individuals

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2021.04.037 ◽

2021 ◽

Author(s):

In Young Cho ◽

Yoosoo Chang ◽

Eunju Sung ◽

Jae-Heon Kang ◽

Hocheol Shin ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Weight Change ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Metabolically Healthy ◽

Alcoholic Fatty Liver Disease

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The Risk of Abdominal Obesity according to the Degree of Non-Alcoholic Fatty Liver Disease in Korean Men

Journal of Korean Medical Science ◽

10.3346/jkms.2016.31.3.410 ◽

2016 ◽

Vol 31 (3) ◽

pp. 410 ◽

Cited By ~ 7

Author(s):

Sung Keun Park ◽

Jae-Hong Ryoo ◽

Joong-Myung Choi ◽

Min Woo Seo ◽

Chung Min Park

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Abdominal Obesity ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Cutoff Points of Abdominal Obesity Indices in Screening for Non-Alcoholic Fatty Liver Disease.

10.1210/endo-meetings.2010.part1.p9.p1-432 ◽

2010 ◽

pp. P1-432-P1-432

Author(s):

SJ Yang ◽

HY Choi ◽

HJ Yoo ◽

YJ Kim ◽

CR Eun ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Abdominal Obesity ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Cutoff Points ◽

Obesity Indices ◽

Alcoholic Fatty Liver Disease

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Less liver fibrosis in metabolically healthy compared with metabolically unhealthy obese patients with non-alcoholic fatty liver disease

Diabetes & Metabolism ◽

10.1016/j.diabet.2017.02.007 ◽

2017 ◽

Vol 43 (4) ◽

pp. 332-337 ◽

Cited By ~ 8

Author(s):

Y. Gutiérrez-Grobe ◽

E. Juárez-Hernández ◽

B.A. Sánchez-Jiménez ◽

M.H. Uribe-Ramos ◽

M.H. Ramos-Ostos ◽

...

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Obese Patients ◽

Alcoholic Fatty Liver ◽

Metabolically Healthy ◽

Alcoholic Fatty Liver Disease

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Non-alcoholic fatty liver disease presence and severity are associated with aortic stiffness beyond abdominal obesity: The ELSA-Brasil

Atherosclerosis ◽

10.1016/j.atherosclerosis.2019.02.005 ◽

2019 ◽

Vol 284 ◽

pp. 59-65 ◽

Cited By ~ 7

Author(s):

Paulo H. Harada ◽

Isabela J.M. Bensenõr ◽

Luciano F. Drager ◽

Alessandra C. Goulart ◽

José G. Mill ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Abdominal Obesity ◽

Fatty Liver Disease ◽

Aortic Stiffness ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Prevalence, risk factors and metabolic profile of the non-obese and obese non-alcoholic fatty liver disease in a rural community of South Asia

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000535 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000535

Author(s):

M Masudur Rahman ◽

Md Golam Kibria ◽

Hasina Begum ◽

Mazhar Haque ◽

Nigar Sultana ◽

...

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Rural Community ◽

Abdominal Obesity ◽

Fatty Liver Disease ◽

Metabolic Profile ◽

Alcoholic Fatty Liver ◽

Obesity Hypertension ◽

Alcoholic Fatty Liver Disease

IntroductionSince there is a paucity of data on the epidemiology of the non-alcoholic fatty liver disease (NAFLD), particularly in rural areas in Asia, we undertook such a study among the population of a rural community in Bangladesh with the aims to (1) determine the prevalence of non-obese and obese NAFLD, (2) compare the sociodemographic clinical and metabolic characteristics between non-obese and obese NAFLD subjects, and (3) determine the risk factors of NAFLD and no-nobese NAFLD.MethodsIn this door-to-door survey, clinical examination, anthropometric measurements, biochemical tests and ultrasonography were performed on the adult population (≥18 years) of three villages in Bangladesh.ResultsOf 1682, 1353 (80.44%) responded. After the exclusion of 48 subjects for alcohol consumption, HBsAg or anti-hepatitis C virus positivity, 1305 ((mean age 41.28±15.10 years, female 908 (69.6%)) were included in the final analysis. On ultrasonography, among the study population, 57 (4.4%) non-obese, 185 (14.2%) obese and, overall, 242 (18.5 %, (male 23.40%, female 16.4%, p=0. 003)) participants had NAFLD. NAFLD was detected in 57/804 (7.1%) of non-obese and 185/501 (36.93%) obese participants. Among the lean subjects, 24/592 (4.1%) had NAFLD. Among NAFLD subjects, 57 (23.55%) were non-obese, and 53 (22%) had raised alanine aminotransferase. On multivariate analysis, age >40 years, male gender, metabolic syndrome (MS), diabetes mellitus (DM), abdominal obesity, hypertension, dyslipidaemia and obesity were found as the risk factors for NAFLD. There were no differences in sociodemographic characteristics, DM, MS, abdominal obesity, hypertension and dyslipidaemia between non-obese and obese NAFLD (all p>0.05).ConclusionIn this community study in Bangladesh, NAFLD was present in 18.5% participants, one-quarter of whom were non-obese. Apart from body mass index, the metabolic profile was comparable between obese and non-obese NAFLD. Public health measures are needed to control and prevent NAFLD and MS and their adverse health consequences.

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A multivariable Mendelian randomization analysis disentangling the causal relations between abdominal obesity, non-alcoholic fatty liver disease and cardiometabolic diseases

10.1101/2021.09.28.21264201 ◽

2021 ◽

Author(s):

William Pelletier ◽

Eloi Gagnon ◽

Emilie Gobeil ◽

Jerome Bourgault ◽

Hasanga D Manikpurage ◽

...

Keyword(s):

Liver Disease ◽

Waist Circumference ◽

Fatty Liver ◽

Abdominal Obesity ◽

Fatty Liver Disease ◽

Mendelian Randomization ◽

Summary Statistics ◽

Alcoholic Fatty Liver ◽

Cardiometabolic Diseases ◽

Alcoholic Fatty Liver Disease

Background: Observational studies have linked obesity and especially abdominal obesity to non-alcoholic fatty liver disease (NAFLD). These traits are also associated with type 2 diabetes (T2D) and coronary artery disease (CAD) but the causal factor(s) underlying these associations remain unexplored. Methods: We used a multivariable Mendelian randomization (MVMR) study design to determine whether obesity (defined using body mass index [BMI]) and abdominal obesity (defined using waist circumference) were causally associated with NAFLD using publicly available genome-wide association study (GWAS) summary statistics of the UK Biobank (n>450,000) and a GWAS meta-analysis of NAFLD (8434 cases and 770,180 control). A MVMR study design was also used to determine the respective causal contributions of waist circumference and NAFLD to T2D and CAD using additional GWAS summary statistics of the DIAGRAM (74,124 cases and 824,006 controls) and CARDIoGRAMplusC4D (122,733 cases and 424,528 controls) consortia. Results: In univariable Mendelian randomization analyses, both BMI and waist circumference were associated with NAFLD. NAFLD was not associated with obesity or abdominal obesity. In MVMR analyses, waist circumference was associated with NAFLD when accounting for BMI (OR per 1-standard deviation increase = 2.56 95% CI: 1.39-4.69, p=2.4e-03) and BMI was not associated with NAFLD when accounting for waist circumference (0.81 95% CI: 0.5-1.31, p =3.9e-01). In MVMR analyses accounting for NAFLD, waist circumference remained strongly associated with both T2D (3.25 95% CI: 2.87-3.68, p=5.1e-77) and CAD (1.62 95% CI: 1.48-1.76, p=6.5e-28). Conclusions: These results identified abdominal obesity as a strong, independent and causal contributor to NAFLD, T2D and CAD, suggesting that interventions targeting abdominal obesity rather than body weight per se should be prioritized for the prevention and management of cardiometabolic diseases.

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