Association of sex-specific body mass index and waist circumference trajectories with non-alcoholic fatty liver disease incidence based on growth mixture modeling

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2024-05, Vol.34 (5), p.1245-1256
• Main Authors: Cao, Tengrui, Tong, Chao, Li, Qiang, Han, Yumei, Halengbieke, Aheyeerke, Ni, Xuetong, Gao, Bo, Zheng, Deqiang, Yang, Xinghua
• Format: Article
• Language: English
• Subjects: Body mass index; confidence interval; disease incidence; fatty liver; Growth mixture modeling; longitudinal studies; metabolism; Non-alcoholic fatty liver disease; nutrition; obesity; odds ratio; regression analysis; Trajectory; Waist circumference
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2024.01.001

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease. The relationship between the trajectories of obesity indicators and incident NAFLD is unknown. Therefore, this study aims to explore the sex-specific association between the trajectories of obesity indicators and the incidence of NAFLD. In total, 9067 participants were recruited for this longitudinal study. Obesity indicators use body mass index (BMI) and waist circumference (WC). The trajectory of obesity indicators was analyzed using the growth mixture modeling. The multivariate logistic regression model was used to analyze the association between obesity indicators' trajectories and incident NAFLD. Over a median follow-up of 1.82 years, 1013 (11.74%) participants developed NAFLD. We identified BMI and WC change trajectories as the stable group, increasing group, and decreasing group. After adjusting for baseline level and other confounders, multivariate logistic regression analysis showed that compared with stable group of BMI, the increasing group, and decreasing group odds ratio and 95% confidence interval of NAFLD were 2.10 (1.06–4.15), and 0.25 (0.09–0.67) in men, and 1.82 (1.08–3.04) and 0.32 (0.16–0.64) in women. Compared with stable group of WC, the increasing group was 2.57 (1.39–4.74) in men, the increasing group, and decreasing group were 2.29 (1.70–3.10) and 0.28 (0.12–0.64) in women. Sensitivity analysis showed that the results were stable. The BMI and WC changing trajectories are significantly associated with the incidence of NAFLD in men and women. Populations of real-world health examinations can be categorized based on obesity indicator changes to prevent NAFLD. •The BMI and WC changing trajectories were associated with NAFLD in men and women.•The increasing trend was the risk factor and the decreasing trend was the protective factor for NAFLD onset.•Deterioration of BMI and WC status can be the sensitive predictors of NAFLD before its occurrence.•Maintaining a low BMI and WC over an extended period is crucial for preventing and treating NAFLD.