Body weight variability and the risk of cardiovascular outcomes in patients with nonalcoholic fatty liver disease

Mi Na Kim,Yeonjung Ha,Young Eun Chon,Seong Gyu Hwang,Juhwan Yoo,Andrew T Chan,Kyungdo Han,Ju Ho Lee,Tracey G Simon

doi:10.1038/s41598-021-88733-3

Abstract

We investigated the association between body weight variability and the risks of cardiovascular disease and mortality in patients with nonalcoholic fatty liver disease (NAFLD) using large-scale, nationwide cohort data. We included 726,736 individuals with NAFLD who underwent a health examination between 2009 and 2010. NAFLD was defined as a fatty liver index ≥ 60, after excluding significant alcohol intake, viral hepatitis, and liver cirrhosis. Body weight variability was assessed using four indices, including variability independent of the mean (VIM). During a median 8.1-year follow-up, we documented 11,358, 14,714, and 22,164 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively. Body weight variability was associated with an increased risk of MI, stroke, and mortality after adjusting for confounding variables. The hazard ratios (HRs) (95% confidence intervals) for the highest quartile, compared with the lowest quartile, of VIM for body weight were 1.15 (1.10–1.20), 1.22 (1.18–1.26), and 1.56 (1.53–1.62) for MI, stroke, and all-cause mortality, respectively. Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in NAFLD patients. Appropriate interventions to maintain a stable weight could positively affect health outcomes in NAFLD patients.

Highlights

We investigated the association between body weight variability and the risks of cardiovascular disease and mortality in patients with nonalcoholic fatty liver disease (NAFLD) using large-scale, nationwide cohort data
Given that the vast majority of NAFLD patients have difficulty maintaining weight loss, and because cardiovascular disease (CVD) is closely associated with NAFLD, investigating of the influence of body weight variability on CVD and mortality in NAFLD patients is crucial to prevent the deleterious consequences of NAFLD
The mean waist circumference and Body mass index (BMI) was highest in quartile 4, and lower in the lower quartiles of variability independent of the mean (VIM)

Summary

Introduction

We investigated the association between body weight variability and the risks of cardiovascular disease and mortality in patients with nonalcoholic fatty liver disease (NAFLD) using large-scale, nationwide cohort data. Body weight variability was associated with an increased risk of MI, stroke, and mortality after adjusting for confounding variables. Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in NAFLD patients. Abbreviations AUROC Area under the receiver operator characteristic curve ARV Average real variability BMI Body mass index CVD Cardiovascular disease CV Coefficient of variation CI Confidence interval FIB-4 Fibrosis-4 index NFS NAFLD fibrosis score FLI Fatty liver index HR Hazard ratio NHIC National Health Insurance Corporation NHIS National Health Insurance Service NAFLD Nonalcoholic fatty liver disease SD Standard deviation VIM Variability independent of the mean. Given that the vast majority of NAFLD patients have difficulty maintaining weight loss, and because CVD is closely associated with NAFLD, investigating of the influence of body weight variability on CVD and mortality in NAFLD patients is crucial to prevent the deleterious consequences of NAFLD

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Results

Conclusion