Weight loss lowers risk of NAFLD in metabolically healthy, overweight people

Metabolically healthy individuals who are overweight or obese may do well to shed a significant amount of weight, as this reduces the risk of developing nonalcoholic fatty liver disease (NAFLD) with or without intermediate or high probability of advanced fibrosis, a study has found.

The study followed for a median of 5.2 years a cohort of 14,779 metabolically healthy men and women with body mass index (BMI) ≥23 kg/m². All of them were free from hepatic steatosis (HS) and an intermediate or high probability of fibrosis at baseline.

A total of 3,539 cases of incident HS (assessed by liver ultrasound and two noninvasive fibrosis scores), with or without liver fibrosis, were recorded during 76,794.6 person-years of follow-up. Clinically significant weight loss was protective against the development of HS, according to multivariable Cox models.

The hazard ratios for HS in reference to individuals whose weight remained stable over the follow-up were 0.52 (95 percent confidence interval [CI], 0.44–0.60) for those who lost ≤5.0 percent of their weight, 0.83 (95 percent CI, 0.75–0.92) for those who lost <5.0 percent or gained <1.0 percent, 1.21 (95 percent CI, 1.10–1.33) for those who gained 1.0–5.0 percent, and 1.51 (95 percent CI, 1.36–1.69) for those who gained >5.0 percent.

Clinically relevant weight loss of >5 percent was also associated with a reduced risk of HS with intermediate or high probability of advanced fibrosis.

Results remained significant on mediation analyses, although the associations were attenuated after adjustment for metabolic risk factors.