Endocrinol Metab.  2021 Aug;36(4):845-854. 10.3803/EnM.2021.1098.

Increased Risk of Nonalcoholic Fatty Liver Disease in Individuals with High Weight Variability

• Jung I
• Koo DJ
• Lee MY
• Moon SJ
• Kwon H
• Park SE
• Rhee EJ
• Lee WY

• KMID: 2519672
• DOI: http://doi.org/10.3803/EnM.2021.1098

Abstract

Background
Weight loss through lifestyle modification is recommended for patients with nonalcoholic fatty liver disease (NAFLD). Recent studies have suggested that repeated loss and gain of weight is associated with worse health outcomes. This study aimed to examine the association between weight variability and the risk of NAFLD in patients without diabetes.
Methods
We examined the health-checkup data of 30,708 participants who had undergone serial examinations between 2010 and 2014. Weight variability was assessed using coefficient of variation and the average successive variability of weight (ASVW), which was defined as the sum of absolute weight changes between successive years over the 5-year period divided by 4. The participants were classified according to the baseline body mass index and weight difference over 4 years.
Results
On dividing the participants into four groups according to ASVW quartile groups, those in the highest quartile showed a significantly increased risk of NAFLD compared to those in the lowest quartile (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.63 to 2.19). Among participants without obesity at baseline, individuals with high ASVW showed increased risk of NAFLD (OR, 1.80; 95% CI, 1.61 to 2.01). Participants with increased weight over 4 years and high ASVW demonstrated higher risk of NAFLD compared to those with stable weight and low ASVW (OR, 4.87; 95% CI, 4.29 to 5.53).
Conclusion
Regardless of participant baseline obesity status, high weight variability was associated with an increased risk of developing NAFLD. Our results suggest that further effort is required to minimize weight fluctuations after achieving a desirable body weight.

Keyword

Body weight maintenance; Body weight changes; Fatty liver; Non-alcoholic fatty liver disease; Obesity; Insulin resistance

Figure

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  Fig. 1 The proportion of participants with nonalcoholic fatty liver disease according to quartiles of the average successive variability of body weight. Cut off value for average successive variability of weight: 1st quartile (<1.13 kg), 2nd quartile (1.13–1.625 kg), 3rd quartile (1.625–2.33 kg), 4th quartile (≥2.33 kg).

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  Fig. 2 Risk of nonalcoholic fatty liver disease (NAFLD) according to the stability of body weight over 4 years and body weight variability. (A) Body weight variability was assessed by average successive variability of weight (ASVW). (B) Body weight variability was assessed by coefficient of variation (CV). CI, confidence interval.

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