Fig. 1Comparison of the proportion of subjects who developed nonalcoholic fatty liver disease (NAFLD) in 2009. MHNO, metabolically healthy, non-obese; MHO, metabolically healthy, obese; MUHNO, metabolically unhealthy, non-obese; MUHO, metabolically unhealthy, obese.
Table 1Baseline Characteristics of the Participants according to the Development of Nonalcoholic Fatty Liver Disease after 4 Years (n=3,045)
Characteristic |
All |
No NAFLD in 2009 (n=2,555) |
NAFLD in 2009 (n=490) |
P value |
Age, yr |
44.2±6.9 |
44.1±6.9 |
44.8±6.5 |
0.034 |
Male sex |
1,625 (53.4) |
1,289 (50.5) |
336 (68.7) |
<0.01 |
BMI, kg/m2
|
22.5±2.5 |
22.2±2.4 |
24.1±2.5 |
<0.01 |
Waist circumference, cm |
76.6±8.3 |
75.7±8.1 |
81.7±7.4 |
<0.01 |
SBP, mm Hg |
110.1±14.3 |
109.6±14.3 |
112.6±14.2 |
<0.01 |
DBP, mm Hg |
73.6±10.1 |
73.1±9.9 |
76.0±10.6 |
<0.01 |
Fasting glucose, mg/dL |
93.7±8.0 |
93.4±7.9 |
95.6±8.3 |
<0.01 |
AST, IU/L |
22.0±6.3 |
21.8±6.4 |
22.7±5.9 |
<0.01 |
ALT, IU/L |
20.2±9.7 |
19.6±9.2 |
23.5±11.0 |
<0.01 |
Total cholesterol, mg/dL |
189.1±31.3 |
187.8±31.0 |
195.7±32.0 |
<0.01 |
Triglyceride, mg/dL |
103.4±54.4 |
97.6±48.9 |
133.7±69.8 |
<0.01 |
HDL-C, mg/dL |
55.4±12.3 |
56.2±12.4 |
50.8±10.1 |
<0.01 |
LDL-C, mg/dL |
108.8±26.0 |
107.5±25.6 |
115.5±26.9 |
<0.01 |
HbA1c, % |
5.39±0.3 |
5.38±0.3 |
5.43±0.3 |
<0.01 |
Fasting insulin, µIU/mL |
7.9±2.8 |
7.8±2.7 |
8.7±3.2 |
<0.01 |
HOMA-IR |
1.85±0.7 |
1.81±0.7 |
2.06±0.8 |
<0.01 |
Table 2Comparison of Parameters among Groups Divided by Baseline Metabolic Health and Obesity Status (n=3,045)
Characteristic |
MHNO (n=2,174) |
MHO (n=299) |
MUHNO (n=396) |
MUHO (n=176) |
Differences among the groups by post hoc analyses |
P value by one-way ANOVA test |
Age, yr |
43.7±6.7 |
45.2±6.9 |
45.4±7.3 |
45.4±7.3 |
I≠II, I≠III, I≠IV |
<0.01 |
Male sex |
995 (45.8) |
201 (67.2) |
283 (71.5) |
146 (83.0) |
- |
<0.01 |
BMI, kg/m2
|
21.6±1.9 |
26.4±1.2 |
22.7±1.6 |
26.6±1.5 |
I≠II, I≠III, I≠IV, II≠III, III≠IV |
<0.01 |
Waist circumference, cm |
74.0±7.2 |
85.9±5.7 |
79.0±6.3 |
88.0±5.3 |
I≠II, I≠III, I≠IV, II≠III, II≠IV, III≠IV |
<0.01 |
SBP, mm Hg |
107.3±12.8 |
112.7±13.5 |
118.7±16.3 |
120.6±15.8 |
I≠II, I≠III, I≠IV, II≠III, II≠IV |
<0.01 |
DBP, mm Hg |
71.3±8.9 |
76.7±9.5 |
79.6±10.7 |
82.6±11.1 |
I≠II, I≠III, I≠IV, II≠III, II≠IV, III≠IV |
<0.01 |
FBG, mg/dL |
92.9±7.6 |
94.4±7.9 |
96.1±8.5 |
97.7±8.5 |
I≠II, I≠III, I≠IV, II≠III, II≠IV, III≠IV |
<0.01 |
AST, IU/L |
21.6±6.2 |
23.0±6.2 |
22.3±6.8 |
23.4±6.8 |
I≠II, I≠III, I≠IV |
<0.01 |
ALT, IU/L |
19.0±8.9 |
23.2±10.3 |
22.4±10.4 |
26.0±12.0 |
I≠II, I≠III, I≠IV |
<0.01 |
Total cholesterol, mg/dL |
187.3±30.8 |
196.0±30.9 |
191.9±32.2 |
194.1±32.5 |
I≠II, I≠III, I≠IV |
<0.01 |
Triglyceride, mg/dL |
87.2±34.1 |
102.6±40.1 |
164.2±72.3 |
168.2±81.9 |
I≠II, I≠III, I≠IV, II≠III, II≠IV |
<0.01 |
HDL-C, mg/dL |
58.1±12.0 |
54.8±10.6 |
45.7±8.3 |
44.3±6.9 |
I≠II, I≠III, I≠IV, II≠III, II≠IV |
<0.01 |
LDL-C, mg/dL |
106.8±25.7 |
116.8±26.4 |
111.1±26.1 |
114.4±24.4 |
I≠II, I≠III, I≠IV, II≠III |
<0.01 |
HbA1c, % |
5.39±0.3 |
5.40±0.3 |
5.40±0.3 |
5.42±0.3 |
- |
0.466 |
Fasting insulin, µIU/mL |
7.5±2.3 |
8.2±2.5 |
9.1±3.4 |
10.9±4.0 |
I≠II, I≠III, I≠IV, II≠III, II≠IV, III≠IV |
<0.01 |
HOMA-IR |
1.71±0.6 |
1.91±0.6 |
2.17±0.8 |
2.65±1.1 |
I≠II, I≠III, I≠IV, II≠III, II≠IV, III≠IV |
<0.01 |
Subjects who developed NAFLD in 2009 |
229 (10.5) |
94 (31.4) |
92 (23.2) |
74 (42) |
- |
<0.01 |
Table 3Logistic Regression Analysis for the Risk of Nonalcoholic Fatty Liver Disease according to Changes in Metabolic Health between Baseline and after 4 Years
Variable |
No. (%) |
P value |
Exp (B) |
95% CI |
Lower |
Upper |
Age |
- |
0.317 |
0.991 |
0.974 |
1.009 |
ALT |
- |
0.049 |
1.011 |
1.000 |
1.023 |
Total cholesterol |
- |
0.047 |
1.004 |
1.000 |
1.007 |
Waist circumference |
- |
<0.01 |
1.074 |
1.056 |
1.092 |
Exercise statusa
|
- |
0.713 |
1.049 |
0.815 |
1.349 |
Gender |
- |
0.674 |
1.062 |
0.803 |
1.404 |
MH→MH |
2,069 (67.9) |
- |
1.000 |
- |
- |
MH→MUH |
404 (13.3) |
<0.01 |
2.720 |
2.041 |
3.623 |
MUH→MH |
224 (7.4) |
<0.01 |
1.503 |
1.014 |
2.229 |
MUH→MUH |
348 (11.4) |
<0.01 |
2.862 |
2.116 |
3.87 |
Table 4Logistic Regression Analysis for the Risk of Nonalcoholic Fatty Liver Disease over 4 Years of Follow-up according to Groups Divided by Baseline Metabolic Health and Obesity Status
Variable |
P value |
Exp (B) |
95% CI |
Lower |
Upper |
Age |
0.262 |
0.991 |
0.976 |
1.007 |
Gender |
0.618 |
1.069 |
0.823 |
1.388 |
ALT |
0.015 |
1.013 |
1.003 |
1.023 |
Total cholesterol |
0.006 |
1.005 |
1.001 |
1.008 |
Waist circumference |
<0.01 |
1.068 |
1.048 |
1.089 |
Exercise statusa
|
0.837 |
1.025 |
0.809 |
1.299 |
MHNO |
- |
- |
- |
- |
MHO |
0.010 |
1.731 |
1.239 |
2.419 |
MUHNO |
<0.01 |
1.877 |
1.412 |
2.494 |
MUHO |
<0.01 |
2.501 |
1.699 |
3.681 |