Abstract
Background: We investigated the effects of anthropometric, laboratory, and lifestyle factors on the development of non-alcoholic fatty liver disease (NAFLD) in a nationwide, population-based, 4-year retrospective cohort.Methods: The propensity score-matched study and control groups contained 1,474 subjects who had data in the Korean National Health Insurance Service-National Sample Cohort in 2009, 2011, and 2013. NAFLD was defined using medical records of a diagnosis confirmed by primary clinicians and meeting two previously validated fatty liver prediction models. Chronological changes in anthropometric variables, laboratory results, and lifestyle factors during two periods were compared between patient and control groups in order to find out parameters with consistent dynamics in pre-NAFLD stage which was defined as period just before the NAFLD development.Results: Among the 5 anthropometric, 10 laboratory, and 3 lifestyle factors, prominent chronological decremental changes in serum triglycerides were consistently observed during the pre-NAFLD stage, although the degrees of changes were more predominant in men (−9.46 mg/dL) than women (−5.98 mg/dL). Furthermore, weight and waist circumference changes during the pre-NAFLD stage were noticeable only in women (+0.36 kg and +0.9 cm for weight and waist circumference, respectively), which suggest gender difference in NAFLD.Conclusion: Early screening strategies for people with abrupt chronological changes in serum triglycerides to predict NAFLD development before the progression is recommended.
Highlights
We investigated the effects of anthropometric, laboratory, and lifestyle factors on the development of non-alcoholic fatty liver disease (NAFLD) in a nationwide, population-based, 4-year retrospective cohort
Chronological changes in anthropometric variables, laboratory results, and lifestyle factors during two periods were compared between patient and control groups in order to find out parameters with consistent dynamics in pre-Non-alcoholic fatty liver disease (NAFLD) stage which was defined as period just before the NAFLD development
Among the 5 anthropometric, 10 laboratory, and 3 lifestyle factors, prominent chronological decremental changes in serum triglycerides were consistently observed during the pre-NAFLD stage, the degrees of changes were more predominant in men (−9.46 mg/dL) than women (−5.98 mg/dL)
Summary
Non-alcoholic fatty liver disease (NAFLD), a disease complex spectrum ranging from benign hepatic steatosis to hepatic inflammation, fibrosis, and cirrhosis, is the leading cause of chronic liver disease in developed countries [1]. Korea has systematic and comprehensive national registry data collected from the Korean National Health Insurance Service-National Sample Cohort (KNHIS-NSC) [10]. The KNHIS-NSC database is a population-based sample cohort. A total of 1,025,340 participants (513,258 men and 512,082 women), 2.2% of the total eligible population in the 2002 Korean nationwide health insurance database, were selected using proportionally allocated, stratified, systematic random sampling with a total medical expenses distribution within strata reflecting gender, age group, qualifications, and income quintile. The data include laboratory results from general health examinations of cohort participants that were followed for 11-years, until 2013. We investigated the effects of anthropometric, laboratory, and lifestyle factors on the development of non-alcoholic fatty liver disease (NAFLD) in a nationwide, population-based, 4-year retrospective cohort
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