Highlights
- •First prospective cohort study investigating NAFLD and fat in blood and body.
- •Fat in blood or body is associated with increasing risk of a diagnosis of NAFLD.
- •The combination of fat in blood and body increases risk of a diagnosis of NAFLD.
Abstract
Background and aims
High caloric diets rich in fat and carbohydrates lead to increased fat accumulation
in adipose tissue and blood. This may lead to increased risk of non-alcoholic fatty
liver disease. We hypothesized that baseline high nonfasting plasma triglycerides,
body mass index (BMI), and waist circumference, individually and combined, associate
with increased risk of clinically diagnosed non-alcoholic fatty liver disease during
follow-up.
Methods
Cohort of 105,981 white Danish individuals recruited in 2003–2015 with end of follow-up
on December 13th, 2018. Mean follow-up was 9.2 years during which time 418 were clinically
diagnosed at hospitals with non-alcoholic fatty liver disease.
Results
Risk of clinically diagnosed non-alcoholic fatty liver disease increased with higher
plasma triglycerides, higher BMI, and with higher waist circumference, continuously
and stepwise using multivariable adjusted hazard ratios and cumulative incidences.
Combining clinical categories of plasma triglycerides with BMI or waist circumference
categories, illustrated an almost additive risk with increasing categories. Compared
with plasma triglycerides of <1 mmol/L and BMI <25 kg/m2, the multivariable adjusted hazard ratio was 5.2(95% confidence interval: 1.3–21.6)
for individuals with both plasma triglycerides of ≥5 mmol/L and BMI ≥35 kg/m2. The corresponding hazard ratio for individuals with plasma triglycerides ≥5 mmol/L
and waist circumference was >88 cm for women and >102 cm for men was 4.8(2.3–9.7).
Triglyceride results were more pronounced in women versus men.
Conclusions
High fat in blood and body measured by plasma triglycerides, BMI, and waist circumference,
individually and especially combined, are associated with up to a 5-fold increased
risk of clinically diagnosed non-alcoholic fatty liver disease.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: May 17, 2023
Accepted:
May 17,
2023
Received in revised form:
May 17,
2023
Received:
November 29,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
