Weight Gain in Young Adulthood Leads to NAFLD Later

Weight gain during young adulthood is associated with a higher risk for non-alcoholic fatty liver disease (NAFLD) in midlife, according to a recent study.

Currently, NAFLD is an epidemic. In order to form effective prevention programs, it is important to determine modifiable risk factors for the development of NAFLD.
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For the CARDIA prospective population-based cohort study, the researchers assessed 4423 participants age 18 to 30 years. Body mass index (BMI) was measured at baseline in 1985 to 1986 and 3 more times over the course of the 25-year follow-up.

At 25 years, liver fat was assessed via noncontrast computed tomography. The researchers defined NAFLD as liver attenuation of 40 Hounsfield units or less after exclusions. Trajectories in BMI percent change over 25 years were determined using latent mixture modeling.

The researchers identified 4 trajectories of BMI percent change, including stable (3.1% change in BMI), moderate increase (21.7% change), high increase (41.9% change), and extreme increase (65.9% change). Results indicated that 26.2% of participants had demonstrated a stable BMI over 25 years, while 46.0% had a moderate increase in BMI, 20.9% had a high increase, and 6.9% had an extreme increase.

The prevalence of NAFLD at year 25 was higher in participants with a greater change in BMI. Multivariable analyses indicated that participants with an increasing percent change in BMI were increasingly more likely to develop NAFLD vs those with a stable BMI.

In the CARDIA cohort, 4.1% of patients with an extreme increase in BMI had developed NAFLD, compared with 13.0% with a high increase, 9.3% with a moderate increase, and 4.1% with a stable BMI.

The researchers noted that associations were only moderately attenuated following adjustment for baseline or year 25 BMI.

“Trajectories of weight gain during young adulthood are associated with greater NAFLD prevalence in midlife independent of metabolic covariates and baseline or concurrent BMI highlighting the importance of weight maintenance throughout adulthood as a target for primary NAFLD prevention,” the researchers concluded.

—Christina Vogt

Reference:

VanWagner LB, Khan SS, Ning H, et al. Body mass index trajectories in young adulthood predict nonalcoholic fatty liver disease in middle age: the CARDIA cohort study [Published online September 29, 2017]. Liver Int. doi:10.1111/liv.13603.