Metabolic Health Is More Important than Obesity in the Development of Nonalcoholic Fatty Liver Disease: A 4-Year Retrospective Study.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3803/EnM.2015.30.4.522
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Min Kyung LEE
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Eun Jung RHEE
			        		
			        		;
		        		
		        		
		        		
			        		Min Chul KIM
			        		
			        		;
		        		
		        		
		        		
			        		Byung Sub MOON
			        		
			        		;
		        		
		        		
		        		
			        		Jeong In LEE
			        		
			        		;
		        		
		        		
		        		
			        		Young Seok SONG
			        		
			        		;
		        		
		        		
		        		
			        		Eun Na HAN
			        		
			        		;
		        		
		        		
		        		
			        		Hyo Sun LEE
			        		
			        		;
		        		
		        		
		        		
			        		Yoonjeong SON
			        		
			        		;
		        		
		        		
		        		
			        		Se Eun PARK
			        		
			        		;
		        		
		        		
		        		
			        		Cheol Young PARK
			        		
			        		;
		        		
		        		
		        		
			        		Ki Won OH
			        		
			        		;
		        		
		        		
		        		
			        		Sung Woo PARK
			        		
			        		;
		        		
		        		
		        		
			        		Won Young LEE
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. drlwy@hanmail.net
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Metabolic health;
			        		
			        		
			        		
				        		Non-alcoholic fatty liver disease;
			        		
			        		
			        		
				        		Obesity
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Blood Glucose;
				        		
			        		
				        		
					        		Body Mass Index;
				        		
			        		
				        		
					        		Cholesterol, HDL;
				        		
			        		
				        		
					        		Fasting;
				        		
			        		
				        		
					        		Fatty Liver*;
				        		
			        		
				        		
					        		Follow-Up Studies;
				        		
			        		
				        		
					        		Homeostasis;
				        		
			        		
				        		
					        		Hypertension;
				        		
			        		
				        		
					        		Obesity*;
				        		
			        		
				        		
					        		Odds Ratio;
				        		
			        		
				        		
					        		Retrospective Studies*;
				        		
			        		
				        		
					        		Triglycerides;
				        		
			        		
				        		
					        		Ultrasonography
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Endocrinology and Metabolism
	            		
	            		 2015;30(4):522-530
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	BACKGROUND: The aim of this study is to compare the risk for future development of nonalcoholic fatty liver disease (NAFLD) according to different status of metabolic health and obesity. METHODS: A total of 3,045 subjects without NAFLD and diabetes at baseline were followed for 4 years. Subjects were categorized into four groups according to the following baseline metabolic health and obesity statuses: metabolically healthy, non-obese (MHNO); metabolically healthy, obese (MHO); metabolically unhealthy, non-obese (MUHNO); and metabolically unhealthy, obese (MUHO). Being metabolically healthy was defined as having fewer than two of the following five components: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostasis model assessment-insulin resistance index. Obesity was defined as a body mass index >25 kg/m2. The presence of NAFLD was assessed by ultrasonography. RESULTS: The proportions of subjects included in the MHNO, MHO, MUHNO, and MUHO groups were 71.4%, 9.8%, 13.0%, and 5.8%, respectively. The proportions of subjects who developed NAFLD were 10.5%, 31.4%, 23.2%, and 42% in the MHNO, MHO, MUHNO, and MUHO groups, respectively. The risk for developing NAFLD was highest in subjects who were metabolically unhealthy both at baseline and after 4 years compared with subjects who were consistently metabolically healthy during the follow-up period (odds ratio, 2.862). Using the MHNO group as reference, the odds ratios for the MHO, MUHNO, and MUHO groups were 1.731, 1.877, and 2.501, respectively. CONCLUSION: The risk for NAFLD was lower in MHO subjects than in MUNO subjects.