Key result
Among Chinese adults, higher body mass index was strongly associated with an increased risk of incident non-alcoholic fatty liver disease, with a hazard ratio of 2.81 per 5 kg/m2 increase.
Why the study?
Adiposity is an increasing public health problem in China, and its associations with NAFLD and other chronic liver diseases in Chinese adults warranted examination.
Does adiposity increase the risk of NAFLD, cirrhosis, and liver cancer in Chinese adults?
Cohort (n=503,991)
Yes
Does adiposity increase the risk of NAFLD, cirrhosis, and liver cancer in Chinese adults?
Hazard Ratio: 2.81 (95% CI 2.63–3.01)
p-value: p=<0.001
In Chinese adults, adiposity is strongly associated with an increased risk of incident NAFLD, but not with other chronic liver diseases such as viral hepatitis.
May aid NAFLD risk stratification in Chinese adults; extends adiposity-NAFLD links but leaves causality open.
Adiposity is an increasing public health problem in China. We aimed to examine the associations of adiposity with non-alcoholic fatty liver disease (NAFLD) and other chronic liver diseases in Chinese adults. The prospective China Kadoorie Biobank recruited 512,891 adults aged 30–79 years from 10 areas. During 10 years of follow-up, 7,386 incident liver disease cases were recorded among 503,991 participants without prior cancer or chronic liver disease at baseline. The mean body mass index (BMI) (SD) was 23.7 (3.3) kg/m 2 and mean waist circumference (WC) 80.3 (9.8) cm, with 33% having BMI ≥25 kg/m 2 . Throughout the range examined (BMI 15–50) BMI showed a log-linear positive association with NAFLD (n = 1,298), with adjusted HR per 5 kg/m 2 of 2.81 (95% CI 2.63–3.01), adjusting for regression dilution. There were also positive associations of percent body fat, WC, and waist-to-hip ratio with NAFLD, with HRs per 1-SD of 2.27 (2.14–2.41), 2.60 (2.44–2.76), and 1.84 (1.76–1.92). BMI was unrelated to viral hepatitis (n = 1,477), and had a U-shaped association with cirrhosis (n = 2,082) and an inverse association with liver cancer (n = 2,568), which disappeared after excluding the first 5 years of follow-up. Among Chinese adults, adiposity was a major risk factor for NAFLD but not other chronic liver diseases.
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Pang et al. (2019) conducted a cohort in Non-alcoholic fatty liver disease (NAFLD) and other chronic liver diseases (n=503,991). Body mass index (BMI) vs. Lower BMI was evaluated on Incident hospital-reported non-alcoholic fatty liver disease (NAFLD) (HR 2.81, 95% CI 2.63-3.01, p=<0.001). Among Chinese adults, higher body mass index was strongly associated with an increased risk of incident non-alcoholic fatty liver disease, with a hazard ratio of 2.81 per 5 kg/m2 increase.
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