Weight gain during early adulthood, trajectory of body shape and the risk of nonalcoholic fatty liver disease: A prospective cohort study among women,Metabolism

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Weight gain during early adulthood, trajectory of body shape and the risk of nonalcoholic fatty liver disease: A prospective cohort study among women
Metabolism ( IF 9.8 ) Pub Date : 2020-10-12 , DOI: 10.1016/j.metabol.2020.154398
Mi Na Kim ₁ , Chun-Han Lo ₂ , Kathleen E Corey ₃ , Po-Hong Liu ₄ , Wenjie Ma ₅ , Xuehong Zhang ₆ , Manol Jovani ₅ , Mingyang Song ₇ , Andrew T Chan ₈ , Tracey G Simon ₉

Affiliation

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, United States of America; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Liver Center, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.

Background & aims

Obesity is established as a major risk factor for the development of nonalcoholic fatty liver disease (NAFLD). However, the influence of dynamic changes in adiposity over the life course on NAFLD risk remains poorly understood.

Methods

We collected data from 110,054 women enrolled in the Nurses' Health Study II cohort. Early adulthood weight was ascertained at age 18 years, and weight gain since early adulthood was defined prospectively every 2 years. We used a group-based modeling approach to identify five trajectories of body shape from age 5 years up to age 50 years. NAFLD was defined by physician-confirmed diagnoses of fatty liver, after excluding excess alcohol intake and viral hepatitis, using validated approaches.

Results

We documented 3798 NAFLD cases over a total of 20 years of follow-up. Compared to women who maintained stable weight (±2 kg), women with ≥20 kg of adulthood weight gain had the multivariable aHR of 6.96 (95% CI, 5.27–9.18), and this remained significant after further adjusting for early adulthood BMI and updated BMI (both P trend <0.0001). Compared to women with a medium-stable body shape trajectory, the multivariable aHRs for NAFLD were, 2.84 (95% CI, 2.50–3.22) for lean-marked increase, 2.60 (95% CI, 2.27–2.98) for medium-moderate increase, and 3.39 (95% CI, 2.95–3.89) for medium-marked increase.

Conclusions

Both early adulthood weight gain and lifetime body shape trajectory were significantly and independently associated with excess risk of developing NAFLD in mid-life. Maintaining both lean and stable weight throughout life may offer the greatest benefit for the prevention of NAFLD.

中文翻译：

成年早期体重增加、体型轨迹和非酒精性脂肪肝风险：一项针对女性的前瞻性队列研究

背景与目标

肥胖被确定为发生非酒精性脂肪性肝病 (NAFLD) 的主要危险因素。然而，人们对生命历程中肥胖的动态变化对 NAFLD 风险的影响仍知之甚少。

方法

我们收集了参加护士健康研究 II 队列的 110,054 名女性的数据。成年早期体重在 18 岁时确定，成年早期体重增加每 2 年前瞻性定义一次。我们使用基于组的建模方法来识别从 5 岁到 50 岁的五种体型轨迹。NAFLD 是由医生确认的脂肪肝诊断定义的，在排除过量饮酒和病毒性肝炎后，使用经过验证的方法。

结果

我们在总共 20 年的随访中记录了 3798 例 NAFLD 病例。与保持稳定体重 (±2 kg) 的女性相比，成年体重增加≥20 kg 的女性的多变量 aHR 为 6.96 (95% CI, 5.27–9.18)，在进一步调整成年早期 BMI 和更新的 BMI（两个P趋势 <0.0001）。与具有中等稳定体型轨迹的女性相比，NAFLD 的多变量 aHR 为，2.84（95% CI，2.50-3.22）表示瘦肉明显增加，2.60（95% CI，2.27-2.98）表示中度增加, 3.39 (95% CI, 2.95–3.89) 为中等显着增加。