Abstract
Body mass index (BMI) is associated with fatty liver risk, however, the dose-response relationship between continuous BMI changes and fatty liver risk has not been clearly defined. In this study, a cross-sectional study was conducted and a total of 3202 individuals were included. Unconditional logistic regression and restricted cubic spline model were used to analyze the dose-response association of BMI with fatty liver risk. After adjusting for confounding factors (age, gender, hypertension, total cholesterol, triglycerides, glucose, high-density lipoprotein, low-density lipoprotein, uric acid, homocysteine, creatinine, aspartate aminotransferase and alanine transaminase), overweight (OR = 3.55, 95% CI: 2.49–5.06, P = 2.79 × 10−12), obesity (OR = 7.59, 95% CI: 4.91–11.71, P = 6.56 × 10−20) were significantly related to fatty liver risk. Stratified by gender (male/female), age (<50 years/≥50 years), prevalence of hypertension (yes/no), the above association was still significant (P = 0.004 or lower). In dose-response analysis, BMI was statistically significantly associated with fatty liver risk in a nonlinear fashion (approximately J-shaped fashion, Pnonlinearity = 1.71 × 10−4 or lower) in the total population and all subgroups mentioned above. Findings from this dose-response analysis suggest that higher BMI (overweight/obesity) is an independent, dose-dependent risk factor for fatty liver, and prevention of fatty liver focusing on continuous changes in BMI should be noted.
Highlights
Fatty liver is a worldwide disease, the prevalence of fatty liver is increasing with great changes in lifestyle
A number of studies reported the association between body mass index (BMI) and fatty liver disease, previous studies were mostly limited to dividing the BMI into categorical variables[4,5,6], which could not show the dose-response relationship
The current study showed that higher BMI was significantly associated with fatty liver risk, among which the risk of fatty liver in overweight population was 3.55 times that of the normal population (OR = 3.55), and the obese population was 7.59 times that of the normal population (OR = 7.59)
Summary
Fatty liver is a worldwide disease, the prevalence of fatty liver is increasing with great changes in lifestyle. As one of the analytical methods describing the dose-response relationship between continuous exposure and outcome, the restricted cubic combines a spline function with a generalized linear model such as logistic regression, and can visually present the effect of small changes of independent variables on the OR value of the corresponding variable by the form of a continuous curve[7,8]. With this method, previous studies found a dose-response relationship between BMI and diabetes and hyperlipidemia[9,10]. We aimed to explore the dose-response relationship between them using the restricted cubic spline model
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
