Hepatology

Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men

Y Chang¹, S Ryu², E Sung³, H-Y Woo⁴, S-I Cho⁵, S-H Yoo⁶, H-Y Ahn⁷, N-K Choi⁸

¹ Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
² Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
³ Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
⁴ Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
⁵ School of Public Health and Institute of Health and Environment, Seoul National University, School of Medicine, Seoul, Korea
⁶ Department of Family Medicine, Sacred Heart Hospital, Hallym University, School of Medicine, Anyang, Korea
⁷ Department of Statistics, Dongguk University, Seoul, Korea
⁸ Medical Research Center, Seoul National University/Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

^{Correspondence to} Dr S Ryu, Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, 108 Pyung dong, Jongro-Gu, Seoul, Korea 110-746; sh703.yoo{at}samsung.com

Objectives: We performed a prospective study to determine whether weight gain predicts future ultrasonographically detected fatty liver (USFL) in a lean adult population.

Methods: Among 15 347 Korean male workers, aged 30–59 years, who participated in a health check-up programme in 2002, a USFL-free cohort of 4246 non-diabetic men was followed until September 2007. Alcohol consumption was assessed by a questionnaire. Weight change for each subject was calculated as the difference between baseline and subsequent measurements. Biochemical tests for liver and metabolic function were done. The primary outcome was ultrasound-diagnosed fatty liver. A standard Cox proportional hazards model and time-dependent Cox model were performed.

Results: During 16 829.7 person-years of follow-up, 622 participants developed USFL. After adjusting for age, the period from visit 1 to visit 2, BMI, HDL-C, triglyceride, uric acid, alanine aminotransferase, and HOMA-IR, the risk for USFL increased with increasing quartiles of weight change (p for trend <0.001). This association remained significant when weight change and covariates, except age and the period from visit 1 to visit 2, were modelled as time-dependent variables. Subjects in the fourth quartile (weight gain 2.3 kg) were at significantly elevated risk for USFL (adjusted hazard ratio (aHR), 1.26; 95% CI, 1.01 to 1.58). These associations did not change, even in normal weight men with a baseline BMI between 18.5 and 22.9 kg/m² (n = 2186).

Conclusion: Weight gain per se appears to increase the risk for developing USFL. Thus, avoiding weight gain, even among lean adult individuals, can be helpful in preventing this disease.

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