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Obesity is more closely related with hepatic steatosis and fibrosis measured by transient elastography than metabolic health status

 Ji Hye Huh  ;  Kwang Joon Kim  ;  Seung Up Kim  ;  Seung Hwan Han  ;  Kwang-Hyub Han  ;  Bong-Soo Cha  ;  Choon Hee Chung  ;  Byung-Wan Lee 
 Metabolism: Clinical and Experimental, Vol.66 : 23-31, 2017 
Journal Title
 Metabolism: Clinical and Experimental 
Issue Date
Adult ; Aged ; Comorbidity ; Elasticity Imaging Techniques ; Female ; Health Status ; Humans ; Liver/diagnostic imaging ; Liver/pathology ; Liver Cirrhosis/complications* ; Liver Cirrhosis/diagnostic imaging ; Liver Cirrhosis/epidemiology ; Male ; Metabolic Syndrome/complications* ; Metabolic Syndrome/diagnostic imaging ; Metabolic Syndrome/epidemiology ; Middle Aged ; Non-alcoholic Fatty Liver Disease/complications* ; Non-alcoholic Fatty Liver Disease/diagnostic imaging ; Non-alcoholic Fatty Liver Disease/epidemiology ; Obesity/complications* ; Obesity/diagnostic imaging ; Obesity/epidemiology ; Obesity/metabolism* ; Obesity, Metabolically Benign/complications* ; Obesity, Metabolically Benign/diagnostic imaging ; Obesity, Metabolically Benign/epidemiology
Liver fibrosis ; Metabolically healthy obese ; Non-alcoholic fatty liver disease ; Transient elastography
OBJECTIVE: The pathogenesis of non-alcoholic fatty liver disease (NAFLD) involves multiple concomitant events induced by obesity and metabolic health condition. This study aimed to assess the risk of NAFLD according to metabolic health and obesity status using transient elastography (TE). MATERIALS AND METHODS: A total of 2198 asymptomatic adults without chronic liver disease and who underwent a medical health check-up were recruited. Subjects were categorized into four groups according to metabolic health and obesity statuses: metabolically healthy non-obese (MHNO); metabolically unhealthy non-obese (MUNO); metabolically healthy obese (MHO); and metabolically unhealthy obese (MUO). Hepatic steatosis was defined as controlled attenuation parameter (CAP)≥238dB/m, and significant liver fibrosis was defined as liver stiffness measurement (LSM) >7.0kPa, as defined by TE. RESULTS: Compared with MHNO group, the odds ratios (ORs) [95% confidence interval (CI)] for hepatic steatosis were 2.94 [2.32-3.71], 4.62 [3.52-6.07], and 12.02 [9.08-15.92] in the MUNO, MHO, and MUO groups, respectively (P<0.001) in crude model. Regarding liver fibrosis, there was no significant difference in the ORs in MUNO group (ORs: 0.95 [95% CI, 0.33-2.78], P value = 0.929), whereas there was a significant increase in the ORs in MHO group compared with MHNO group (ORs: 4.32 [95% CI, 1.73-10.76], P=0.002) in the fully adjusted model. CONCLUSION: Our results show that MHO was associated with both liver steatosis and fibrosis assessed by transient elastography. Our results suggest that a healthy metabolic profile does not protect obese adults from hepatic steatosis or fibrosis, indicating that obesity itself might contribute to liver fibrosis.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Han, Seung Hwan(한승환) ORCID logo https://orcid.org/0000-0002-7975-6067
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