A weight regain of 1.5\xa0kg or more and lack of exercise are associated with nonalcoholic fatty liver disease recurrence in men

Naoko Nakanishi,Yoshitaka Hashimoto,Takuro Okamura,Takao Kojima,Michiaki Fukui,Masahide Hamaguchi,Akihiro Ohbora

doi:10.1038/s41598-021-99036-y

Abstract

The importance of maintaining the remission of nonalcoholic fatty liver disease (NAFLD) has been overlooked. Here we aimed to clarify factors causing NAFLD recurrence. In this retrospective cohort study over 10.8 ± 5.4 years, we investigated 1260 male health check-up participants diagnosed with NAFLD who achieved remission. The data were compared between the maintained remission and recurrence group. Among all participants, 618 (49.0%) showed NAFLD recurrence at the last visit. Participants in the maintained remission group continued to lose weight (72.7 ± 9.1, 68.7 ± 8.5 and 68.2 ± 8.9 kg), whereas those in the recurrence group lost and regained weight (72.9 ± 9.9, 69.7 ± 9.3 and 73.0 ± 10.4 kg). Receiver operating characteristic curve analysis showed a weight regain of + 1.5 kg as the cutoff value for recurrence. The proportion of regular exercisers at the last visit was 34.6% in the maintained remission group and 24.5% in the recurrence group (p < 0.0001). Multivariable analysis revealed the amount of weight regain (in 1 kg increments; adjusted odds ratio, 1.29; 95% confidence interval, 1.24–1.34) and regular exercise at the last visit (adjusted odds ratio, 0.67; 95% confidence interval, 0.55–0.89) were independently associated with recurrence. These findings demonstrate a weight regain of 1.5 kg or more and lack of exercise were associated with NAFLD recurrence.

Highlights

The importance of maintaining the remission of nonalcoholic fatty liver disease (NAFLD) has been overlooked
As the importance of maintaining NAFLD remission has been rather overlooked, little is known about the crucial factors related to NAFLD recurrence
There were no significant differences between the maintained NAFLD remission and recurrence group in body weight or body mass index (BMI) at baseline (Table 1)

Summary

Introduction

The importance of maintaining the remission of nonalcoholic fatty liver disease (NAFLD) has been overlooked. Multivariable analysis revealed the amount of weight regain (in 1 kg increments; adjusted odds ratio, 1.29; 95% confidence interval, 1.24–1.34) and regular exercise at the last visit (adjusted odds ratio, 0.67; 95% confidence interval, 0.55–0.89) were independently associated with recurrence. A fair number of studies examined the factors contributing to NAFLD recurrence after liver transplantation[18,19], very few studies have investigated the natural history of patients who achieved remission through lifestyle changes. The factors that determine whether individuals maintain NAFLD remission or develop recurrence remain unclear To answer this question, we designed this retrospective cohort analysis of health check-up participants and examined changes in lifestyle history such as exercise and smoking habits obtained by questionnaires as well as clinical and laboratory data including metabolic syndrome parameters. Considering that sex differences do exist in the prevalence and risk factors of NAFLD20, we analyzed the data separately by sex

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