Nonalcoholic fatty liver disease is an early predictor of metabolic diseases in a metabolically healthy population

• Published in: PloS one 2019-11, Vol.14 (11), p.e0224626-e0224626
• Main Authors: Yang, Seokhun, Kwak, Soongu, Lee, Jeong-Hoon, Kang, Shinae, Lee, Seung-Pyo
• Format: Article
• Language: English
• Subjects: Adult; Age; Alcoholism; Atherosclerosis; Biology and Life Sciences; Body mass; Body Mass Index; Body size; Cardiology; Codes; Complications and side effects; Confidence intervals; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diagnosis; Dyslipidemia; Fatty liver; Female; Follow-Up Studies; Health; Health hazards; Hospitals; Humans; Hypertension; Incidence; Insulin resistance; Insurance; Internal medicine; Liver; Liver diseases; Male; Medical research; Medicine; Medicine and Health Sciences; Metabolic diseases; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Metabolic Syndrome - metabolism; Middle Aged; National health insurance; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - metabolism; Obesity; Population; Proportional Hazards Models; Republic of Korea - epidemiology; Risk Assessment - methods; Risk Factors; Smoking; Steatosis; Studies; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0224626

The relationship between nonalcoholic fatty liver disease and incident metabolic syndrome in metabolically healthy subjects is unknown. We aimed to investigate whether nonalcoholic fatty liver disease is a predictor of future metabolic syndrome in metabolically healthy subjects. Subjects who underwent health evaluation at least twice between 2009 and 2015 from the National Health Insurance Service-National Sample Cohort in South Korea were included. Patients without obesity who had no metabolic syndrome components were finally analyzed (n = 28,880). The definition of nonalcoholic fatty liver disease was based on both the hepatic steatosis and fatty liver indices. The incidence of metabolic syndrome, prediabetes/type 2 diabetes, hypertension, and dyslipidemia was compared between the subjects with and without nonalcoholic fatty liver disease. The presence of nonalcoholic fatty liver disease was associated with a higher risk of incident metabolic syndrome, prediabetes/type 2 diabetes, hypertension, and dyslipidemia in the entire cohort (metabolic syndrome: adjusted hazard ratio, 2.10; 95% confidence interval, 1.18-3.71; prediabetes/type 2 diabetes: adjusted hazard ratio, 1.42; 95% confidence interval, 1.06-1.90; hypertension: adjusted hazard ratio, 2.36; 95% confidence interval, 1.35-4.12; dyslipidemia: adjusted hazard ratio, 1.49; 95% confidence interval, 1.07-2.06). A similar finding was observed in the age-, sex-, smoking status-, and body mass index-based 1:5 propensity score-matched cohort of 1,092 subjects (metabolic syndrome: adjusted hazard ratio, 3.56; 95% confidence interval, 1.79-7.07; prediabetes/type 2 diabetes: adjusted hazard ratio, 1.97; 95% confidence interval, 1.04-3.73; hypertension: adjusted hazard ratio, 2.57; 95% confidence interval, 1.35-4.88; dyslipidemia: adjusted hazard ratio, 1.61; 95% confidence interval, 1.12-2.32). Nonalcoholic fatty liver disease is an early predictor of metabolic dysfunction even in metabolically healthy populations.