MASLD, At-Risk MASH and Increased Liver Stiffness Are Associated With Young Adulthood Obesity Without Residual Risk After Losing Obesity.

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Liver International Pub Date : 2024-11-22 DOI:10.1111/liv.16169

Laurens A van Kleef, Jesse Pustjens, Mesut Savas, Ibrahim Ayada, Pengfei Li, Qiuwei Pan, Elisabeth F C van Rossum, Harry L A Janssen, Willem P Brouwer

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Abstract

Background: Obesity can result in persistent metabolic changes despite weight loss, which may affect liver health. We aimed to investigate associations between young adulthood obesity and metabolic dysfunction-associated steatotic liver disease (MASLD), at-risk steatohepatitis and increased liver stiffness measurement (LSM) in a general population setting.

Methods: We studied NHANES 2017-2020 community-dwelling participants aged > 40 years with BMI ≥ 18.5 and no heart failure. Weight at age 25 was obtained through questionnaires and compared to current weight. Assessment included controlled attenuation parameter (CAP) and LSM. Associations between obesity status change with MASLD or at-risk metabolic dysfunction-associated steatohepatitis (MASH) and increased LSM were investigated and adjusted for demographics and metabolic health.

Results: The cohort comprised 4,580 participants (57% stable non-obesity, 33% gained obesity, 2% lost obesity and 8% stable obesity). Compared to stable no-obesity, stable obesity was strongly associated with MASLD (odds ratio [OR]: 5.47, 95% confidence interval [95%CI]: 3.97-7.66) as was gained obesity (OR: 4.68, 95% CI: 3.93-5.59), whereas no increased risk was demonstrated for lost obesity (OR: 1.26, 95% CI: 0.76-2.10). Similar associations for stable obesity and gained obesity with at-risk MASH and LSM ≥ 8 kPa were demonstrated. No residual risk was found for lost obesity (MASH-OR: 1.05 95% CI: 0.36-2.49; LSM ≥ 8 kPa-OR: 0.85, 95% CI: 0.29-1.97). Results were consistent in sensitivity analysis where obesity change was calculated over the past 10 years and weight change was stratified in normal weight/overweight/obesity.

Conclusion: Young adulthood obesity is an important risk factor for MASLD, at-risk MASH and increased LSM among the general population aged 40-80 years. Losing obesity resulted in normalisation of odds for MASLD, at-risk MASH and increased LSM. These findings underline the importance of preventing and treating young adulthood obesity to maintain liver health.

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MASLD、高危 MASH 和肝脏僵硬度增加与青年肥胖症有关，但肥胖症消失后无残留风险。

背景：尽管体重有所减轻，但肥胖会导致持续的代谢变化，这可能会影响肝脏健康。我们的目的是在普通人群中调查青年期肥胖与代谢功能障碍相关性脂肪性肝病（MASLD）、高危脂肪性肝炎和肝脏硬度测量（LSM）增加之间的关联：我们研究了年龄大于 40 岁、体重指数≥ 18.5 且无心力衰竭的 NHANES 2017-2020 年社区居民参与者。25岁时的体重通过问卷调查获得，并与当前体重进行比较。评估包括受控衰减参数（CAP）和 LSM。研究调查了肥胖状态变化与MASLD或高危代谢功能障碍相关性脂肪性肝炎（MASH）和LSM增加之间的关系，并对人口统计学和代谢健康状况进行了调整：组群包括 4580 名参与者（57% 为稳定非肥胖，33% 为肥胖增加，2% 为肥胖减少，8% 为稳定肥胖）。与稳定非肥胖相比，稳定肥胖与MASLD密切相关（比值比[OR]：5.47，95% 置信区间[95%CI]：3.97-7.66），肥胖增加也与MASLD密切相关（比值比：4.68，95% CI：3.93-5.59），而肥胖消失的风险没有增加（比值比：1.26，95% CI：0.76-2.10）。稳定型肥胖和获得型肥胖与高风险的 MASH 和 LSM ≥ 8 kPa 有相似的关联。未发现丢失性肥胖的残余风险（MASH-OR：1.05 95% CI：0.36-2.49；LSM ≥ 8 kPa-OR：0.85，95% CI：0.29-1.97）。在敏感性分析中，计算过去10年的肥胖变化，并将体重变化按正常体重/超重/肥胖进行分层，结果是一致的：结论：在 40-80 岁的普通人群中，年轻时的肥胖是导致 MASLD、高危 MASH 和 LSM 增加的重要风险因素。减少肥胖可使MASLD、高危MASH和LSM增加的几率趋于正常。这些发现强调了预防和治疗青壮年肥胖对维护肝脏健康的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.