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Body mass index trajectories in young adulthood predict non‐alcoholic fatty liver disease in middle age: The CARDIA cohort study
Author(s) -
VanWagner Lisa B.,
Khan Sadiya S.,
Ning Hongyan,
Siddique Juned,
Lewis Cora E.,
Carr John J.,
Vos Miriam B.,
Speliotes Elizabeth,
Terrault Norah A.,
Rinella Mary E.,
LloydJones Donald M.,
Allen Norrina B.
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13603
Subject(s) - fatty liver , body mass index , medicine , cohort , population , alcoholic liver disease , odds ratio , cohort study , liver disease , gastroenterology , disease , cirrhosis , environmental health
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.