Cardiometabolic risk tied to NAFLD

Cardiometabolic risk factors increase the risk of nonalcoholic fatty liver disease (NAFLD), though such interactions seem to vary between lean and nonlean individuals, a recent study has found.

Researchers looked at longitudinal data from 6,513 individuals (mean age 43.9 years, 32.4 percent women) who undergo yearly voluntary routine health testing. NAFLD, the primary dependent variable, was diagnosed through hepatic ultrasound. Main exposure variables included blood glucose, blood pressure (BP), physical activity, and atherogenic dyslipidaemia (AD).

Around half of the participants had body mass index (BMI) 18.5–24.9 kg/m² and were designated as lean (n=3,293; 50.6 percent); 42.4 percent were overweight (BMI 25–29.9 kg/m²) and 7.1 percent were obese (BMI >30 kg/m²). Over 15,580 person-years of follow-up, the resulting incidence rate of NAFLD was 7.7 per 100 person-years.

Multivariate analysis found that physical inactivity (adjusted incidence rate ratio [IRR], 1.46, 95 percent confidence interval [CI], 1.28–1.66), the presence of AD (adjusted IRR, 1.72, 95 percent CI, 1.32–2.23), and elevated glucose (adjusted IRR, 1.71, 95 percent CI, 1.29–2.28) were significant risk factors for NAFLD.

The same was true for high-sensitivity C-reactive protein (hs-CRP) levels (adjusted IRR, 1.35, 95 percent CI, 1.12–1.63) but not BP (adjusted IRR, 1.19, 95 percent CI, 0.96–1.48).

Of note, the effect of the various cardiometabolic factors on NAFLD risk varied by BMI. For example, ADP remained a significant correlate of NAFLD in lean participants, while the impact of physical activity, blood glucose, and hs-CRP were all attenuated. BP was also significantly correlated with NAFLD in lean participants (adjusted IRR, 1.83, 95 percent CI, 1.08–3.10).

In nonlean individuals (BMI ≥25 kg/m²), all cardiometabolic risk factors except for BP were significantly associated with NAFLD.