YANG Chenlu, ZHAO Xinyu, HU Shiqi, LAN Yanqi, FENG Baoyu, WANG Li. Weight Control and Non-alcoholic Fatty Liver Disease: Evidence from China[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 44-49. DOI: 10.12290/xhyxzz.2022-0691
Citation: YANG Chenlu, ZHAO Xinyu, HU Shiqi, LAN Yanqi, FENG Baoyu, WANG Li. Weight Control and Non-alcoholic Fatty Liver Disease: Evidence from China[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 44-49. DOI: 10.12290/xhyxzz.2022-0691

Weight Control and Non-alcoholic Fatty Liver Disease: Evidence from China

Funds: 

The Capital Health Research and Development of Special 2022-1-2021

More Information
  • Corresponding author:

    WANG Li, E-mail: liwang@ibms.pumc.edu.cn

  • Received Date: December 02, 2022
  • Accepted Date: January 08, 2023
  • Issue Publish Date: January 29, 2023
  • Based on the clinical trials and cohort studies in the Chinese population, this paper systematically summarized the association between weight/ body mass index (BMI) and their changes in preventing non-alcoholic fatty liver disease (NAFLD) and its adverse outcomes. The results showed that BMI was positively correlated with NAFLD risk, but for those with NAFLD, BMI was negatively related to the remission of NAFLD and there was a non-linear dose-response relationship between BMI and adverse outcomes. The lean NAFLD group had a higher risk of all-cause death, liver-related death, digestive system tumors, and obesity-related tumors than the overweight or obese NAFLD and lean non-NAFLD group. Additionally, the association between baseline BMI levels and adverse outcomes in NAFLD populations may be affected by other metabolic indicators. After controlling for baseline BMI, most studies suggested that weight loss could reduce the NAFLD risk. However, there is no consistent conclusion on how to control weight to prevent NAFLD because the methods and the time windows to assess BMI changes vary in different studies. Moreover, for those with NAFLD, limited evidence suggested the different relationship between weight loss and different outcomes. Therefore, we call for conducting multi-center cohort and experimental studies to verify the effect of weight control on NAFLD and its related adverse outcomes after considering the heterogeneity of NAFLD, so as to propose precision weight control recommendations.
  • [1]
    Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes [J]. Hepatology, 2016, 64: 73-84. DOI: 10.1002/hep.28431
    [2]
    Lee HW, Wong VW. Changing NAFLD Epidemiology in China [J]. Hepatology, 2019, 70: 1095-1098. DOI: 10.1002/hep.30848
    [3]
    Byrne CD, Targher G. NAFLD as a driver of chronic kidney disease [J]. J Hepatol, 2020, 72: 785-801.
    [4]
    Byrne CD, Perseghin G. Non-alcoholic fatty liver disease: A risk factor for myocardial dysfunction? [J]. J Hepatol, 2018, 68: 640-642. DOI: 10.1016/j.jhep.2017.12.002
    [5]
    Hagstrom H, Talback M, Andreasson A, et al. Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease [J]. J Hepatol, 2020, 73: 1023-1029. DOI: 10.1016/j.jhep.2020.06.007
    [6]
    Wang Z, Zhao X, Chen S, et al. Associations Between Nonalcoholic Fatty Liver Disease and Cancers in a Large Cohort in China [J]. Clin Gastroenterol Hepatol, 2021, 19: 788-796. e4. DOI: 10.1016/j.cgh.2020.05.009
    [7]
    Rinella M, Charlton M. The globalization of nonalcoholic fatty liver disease: Prevalence and impact on world health [J]. Hepatology, 2016, 64: 19-22.
    [8]
    中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018年更新版) [J]. 实用肝脏病杂志, 2018, 21: 177-186. DOI: 10.3969/j.issn.1672-5069.2018.02.007
    [9]
    European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease [J]. J Hepatol, 2016, 64: 1388-1402.
    [10]
    Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases [J]. Hepatology, 2018, 67: 328-357. DOI: 10.1002/hep.29367
    [11]
    Chitturi S, Wong VW, Chan WK, et al. The Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 2: Management and special groups [J]. J Gastroenterol Hepatol, 2018, 33: 86-98.
    [12]
    Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease [J]. Lancet, 2021, 397: 2212-2224. DOI: 10.1016/S0140-6736(20)32511-3
    [13]
    Diehl AM, Day C. Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis [J]. N Engl J Med, 2017, 377: 2063-2072. DOI: 10.1056/NEJMra1503519
    [14]
    Ye Q, Zou B, Yeo YH, et al. Global prevalence, inci-dence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis [J]. Lancet Gastroenterol Hepatol, 2020, 5: 739-752. DOI: 10.1016/S2468-1253(20)30077-7
    [15]
    Baratta F, D'erasmo L, Bini S, et al. Heterogeneity of non-alcoholic fatty liver disease (NAFLD): Implication for cardiovascular risk stratification [J]. Atherosclerosis, 2022, 357: 51-59. DOI: 10.1016/j.atherosclerosis.2022.08.011
    [16]
    Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD) [J]. Endocr Pract, 2022, 28: 528-562. DOI: 10.1016/j.eprac.2022.03.010
    [17]
    Quek J, Chan KE, Wong ZY, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis [J]. Lancet Gastroenterol Hepatol, 2023, 8: 20-30. DOI: 10.1016/S2468-1253(22)00317-X
    [18]
    Yi M, Chen RP, Yang R, et al. Increased prevalence and risk of non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes in South China [J]. Diabet Med, 2017, 34: 505-513. DOI: 10.1111/dme.13174
    [19]
    Li L, Liu DW, Yan HY, et al. Obesity is an independent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies [J]. Obes Rev, 2016, 17: 510-519. DOI: 10.1111/obr.12407
    [20]
    Guan X, Zhang Q, Xing J, et al. Systolic Blood Pressure Mediates Body Mass Index and Non-alcoholic Fatty Liver Disease: A Population-Based Study [J]. Turk J Gastroenterol, 2021, 32: 458-465. DOI: 10.5152/tjg.2021.20641
    [21]
    霍艳蓓, 白亚娜, 张德生, 等. 金昌队列人群非酒精性脂肪肝发病的影响因素分析[J]. 中华流行病学杂志, 2021, 42: 493-498. DOI: 10.3760/cma.j.cn112338-20200428-00668
    [22]
    余馨妍, 赵奕, 宋筱筱, 等. 人体质量指数与非酒精性脂肪性肝病发生和消退的关系[J]. 浙江大学学报(医学版), 2014, 43: 546-552. DOI: 10.3785/j.issn.1008-9292.2014.09.010
    [23]
    Wu J, He S, Xu H, et al. Non-alcoholic fatty liver disease incidence, remission and risk factors among a general Chinese population with a 6-year follow-up [J]. Sci Rep, 2018, 8: 7557. DOI: 10.1038/s41598-018-25641-z
    [24]
    Lan Y, Lu Y, Li J, et al. Outcomes of subjects who are lean, overweight or obese with nonalcoholic fatty liver disease: A cohort study in China [J]. Hepatol Commun, 2022, 6: 3393-3405. DOI: 10.1002/hep4.2081
    [25]
    胡诗琪. 基于开滦队列的非酒精性脂肪性肝病亚型分类及其健康效应研究[D]. 北京: 中国医学科学院北京协和医学院, 2022.
    [26]
    王珊, 张健, 张杰, 等. 体质量指数轨迹与新发非酒精性脂肪性肝病相关性的队列研究[J]. 中华肝脏病杂志, 2020, 28: 597-602. DOI: 10.3760/cma.j.cn501113-20190629-00230
    [27]
    Tong C, Li Q, Kong L, et al. Sex-specific metabolic risk factors and their trajectories towards the non-alcoholic fatty liver disease incidence [J]. J Endocrinol Invest, 2022, 45: 2233-2245. DOI: 10.1007/s40618-022-01848-w
    [28]
    Du S, Wang C, Jian W, et al. The impact of body weight gain on nonalcoholic fatty liver disease and metabolic syndrome during earlier and later adulthood [J]. Diabetes Res Clin Pract, 2016, 116: 183-191. DOI: 10.1016/j.diabres.2016.04.047
    [29]
    Feng B, Chen S, Wang X, et al. Effect of cumulative body mass index exposure and long-term related change on incident non-alcoholic fatty liver disease [J]. Liver Int, 2022. doi: 10.1111/liv.15436.
    [30]
    Liu M, Wang J, Zeng J, et al. Association of NAFLD With Diabetes and the Impact of BMI Changes: A 5-Year Cohort Study Based on 18, 507 Elderly [J]. J Clin Endocrinol Metab, 2017, 102: 1309-1316. DOI: 10.1210/jc.2016-3440
    [31]
    Zhang HJ, He J, Pan LL, et al. Effects of Moderate and Vigorous Exercise on Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial [J]. JAMA Intern Med, 2016, 176: 1074-1082. DOI: 10.1001/jamainternmed.2016.3202
    [32]
    Hu S, Li X, Sun Y, et al. Short-term weight loss decreased the risk of chronic kidney disease in men with incident nonalcoholic fatty liver disease [J]. Obesity (Silver Spring), 2022, 30: 1495-1506. DOI: 10.1002/oby.23459
    [33]
    胡诗琪, 蓝彦琦, 吴寿岭, 等. 肥胖及其变化对中国华北新发NAFLD成年男性患者心血管疾病发病风险的影响[J]. 基础医学与临床, 2022, 42: 788-794. DOI: 10.3969/j.issn.1001-6325.2022.05.015
    [34]
    Pan WH, Yeh WT. How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations [J]. Asia Pac J Clin Nutr, 2008, 17: 370-374.
    [35]
    Arrese M, Arab JP, Barrera F, et al. Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity [J]. Semin Liver Dis, 2021, 41: 421-434.
    [36]
    Dasarathy S, Dasarathy J, Khiyami A, et al. Validity of real time ultrasound in the diagnosis of hepatic steatosis: a prospective study [J]. J hepatol, 2009, 51: 1061-1067. DOI: 10.1016/j.jhep.2009.09.001
    [37]
    Wai JW, Fu C, Wong VW. Confounding factors of non-invasive tests for nonalcoholic fatty liver disease [J]. J Gastroenterol, 2020, 55: 731-741. DOI: 10.1007/s00535-020-01686-8
    [38]
    Wong VW, Adams LA, De Lédinghen V, et al. Noninvasive biomarkers in NAFLD and NASH-current progress and future promise [J]. Nat Rev Gastroenterol Hepatol, 2018, 15: 461-478.
  • Related Articles

    [1]CHEN Hongda, CHEN Wanqing. Evaluation of Cancer Burden Based on Big Data: Applications and Challenges in Cancer Prevention and Treatment[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(2): 506-512. DOI: 10.12290/xhyxzz.2025-0083
    [2]LOU Ying, CAI Jun. Moving Forward the Defense Line and Wasting No Time: The Era of Active Prevention and Control of Hypertension in China Has Come[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1238-1241. DOI: 10.12290/xhyxzz.2024-0774
    [3]PAN Yuhui, SANG Wentao, BIAN Yuan, XU Feng. Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Hig-risk Factors and Prevention[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 465-471. DOI: 10.12290/xhyxzz.2022-0627
    [4]LI Yi, XU Yingchun. A New Chapter in the COVID-19 Pandemic: the Characteristics of Omicron Variant and A New Step for Scientific Epidemic Prevention and Control[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 9-17. DOI: 10.12290/xhyxzz.2022-0697
    [5]XU Fen, ZHOU Zhou. Heart Failure: Prevention and Treatment are Indispensable[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 953-957. DOI: 10.12290/xhyxzz.2022-0440
    [6]Chao WANG, Yang-yu ZHAO. Standardize Clinical Medication and Improve Maternal and Neonatal Outcomes: Interpretation on Prevention of Group B Streptococcal Early-onset Disease in Newborns: ACOG Committee Opinion, Number 797[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 402-407. DOI: 10.3969/j.issn.1674-9081.2020.04.008
    [7]Di ZHONG, Bo WU. Will the Strategies of Stroke Prevention Change with the New Diagnostic Standard of Hypertension?[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 103-107. DOI: 10.3969/j.issn.1674-9081.2019.02.003
    [8]Ying-xian SUN. Suggestion on China Mode of Prevention, Diagnosis and Treatment of Hypertension[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 97-99. DOI: 10.3969/j.issn.1674-9081.2019.02.001
    [9]Fenglin Liu, Jing Qin. From Guidelines to Practice: Analysis of Guidelines for Prevention and Management of Perioperative Venous Thrombosis in General Surgery in China[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 144-149. DOI: 10.3969/j.issn.1674-9081.2018.02.008
    [10]Ying ZHANG, Jin-song GAO, Jun-tao LIU, Hai-yuan LIU, Ying-na SONG, Xiao-ming GONG, Zhi-jing SUN. Effectiveness of B-lynch Suture in Treatment and Prevention of Postpartum Hemorrhage[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(2): 174-177. DOI: 10.3969/j.issn.1674-9081.2013.02.019
  • Cited by

    Periodical cited type(4)

    1. 窦紫岩,钱文红,孔邻润,陈晔,李明亮,张静波. 非酒精性脂肪性肝病检出率现状及其影响因素:基于北京市32万人群数据. 中国全科医学. 2024(02): 144-149+155 .
    2. 王伟,缪海江,王新宇. 木香流气饮联合多烯磷脂酰胆碱胶囊对非酒精性脂肪肝肝郁脾虚证患者的效果观察. 深圳中西医结合杂志. 2024(06): 46-49 .
    3. 韩炜,宋叶君,张改萍,田晓英,付素芳,赵芳,王俊,周冉,张思宇,杜金星. 非酒精性脂肪肝病人健康减重的证据总结. 全科护理. 2024(23): 4450-4453 .
    4. 吴风,孔丽蕊,谭志群. 2型糖尿病合并NAFLD患者铁蛋白、TyG-BMI变化及与脂肪变性程度的相关性. 新疆医科大学学报. 2023(10): 1338-1343 .

    Other cited types(2)

Catalog

    Article Metrics

    Article views (2863) PDF downloads (257) Cited by(6)
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close