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Metabolically healthy and unhealthy obesity and the progression of liver fibrosis: A cross-sectional study - 11/11/21

Doi : 10.1016/j.clinre.2021.101754 
Helda Tutunchi a, Fatemeh Naeini b, Mehrangiz Ebrahimi-Mameghani c, Farzad Najafipour d, Majid Mobasseri d, Alireza Ostadrahimi a,
a Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran 
b Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran university of medical science, Tehran, Iran 
c Social Determinant of Health Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran 
d Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 

Corresponding authors at: Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.Nutrition Research CenterDepartment of Clinical NutritionSchool of Nutrition and Food SciencesTabriz University of Medical SciencesTabrizIran

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Highlights

The development of liver fibrosis is the most important predictor of adverse outcomes in patients with NAFLD.
The association of liver fibrosis with metabolically healthy and unhealthy obesity was assessed in adult patients with NAFLD.
Excess body fat contributes to the progression of liver fibrosis regardless of metabolic health status.

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Abstract

Background

The development of liver fibrosis is the most important predictor of adverse outcomes in patients with non-alcoholic fatty liver disease (NAFLD). Little is known regarding the risk factors for the progression of NAFLD to liver fibrosis. The present cross-sectional study aimed to examine the association of liver fibrosis with metabolically healthy and unhealthy obesity among patients with NAFLD.

Methods

The severity of fatty liver was examined using ultrasonography. We used the NAFLD fibrosis score to determine the severity of liver fibrosis. Anthropometric indices, physical activity, and body composition were assessed. Blood samples were collected to determine serum metabolic parameters. Participants without any component of metabolic syndrome and homeostasis model assessment of insulin resistance (HOMA-IR) <2.5 were considered as metabolically healthy. To examine the association of liver fibrosis with metabolically healthy and unhealthy obesity, multivariable-adjusted odds ratios (ORs) were applied.

Results

The current study included a total of 246 patients with NAFLD and low probability of fibrosis. 46.3% of subjects were metabolically healthy and 53.7% were metabolically unhealthy. Among metabolically healthy subjects, multivariable‐adjusted ORs (CIs) for worsening of NAFLD fibrosis score comparing body mass indexes (BMIs) 23.0–24.9, 25–29.9, and ≥30 with a BMI=18.5–22.9 kg/m2 were 1.28 (1.09‐1.56), 1.99 (1.49‐2.63), and 3.96 (2.89‐4.71), respectively. The corresponding ORs (95% CIs) among metabolically unhealthy subjects were 1.39 (1.32‐1.64), 2.27 (1.98‐2.49), and 4.11 (3.12‐4.93), respectively. Moreover, in both healthy and unhealthy individuals, higher percentages of body fat and waist circumference were significantly associated with worsening of NAFLD fibrosis score.

Conclusion

Excess body fat contributes to the progression of liver fibrosis regardless of metabolic health status.

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Abbreviations : ALT, AST, BF%, BMI, FBS, HDL‐C, HOMA-IR, LDL‐C, MHO, MUO, NAFLD, ORs, TC, TG, WC


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Vol 45 - N° 6

Articolo 101754- Novembre 2021 Ritorno al numero
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