1Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
2Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Copyright © 2020 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest associated with the material presented in this paper.
FUNDING
None.
AUTHOR CONTRIBUTIONS
Conceptualization: JS, HKC. Data curation: JS. Formal Analysis: JS. Funding acquisition: None. Methodology: JS, HKC. Writing – original draft: JS. Writing – review & editing: JS, HKC, SR, YMS.
Characteristics |
Male |
Female |
||||
---|---|---|---|---|---|---|
Presence of NAFLD at baseline |
p-value1 |
Presence of NAFLD at baseline |
p-value1 | |||
No (n=572) | Yes (n=434) | No (n=3084) | Yes (n=446) | |||
Age (y) | 49.0±10.2 | 49.6±9.3 | 0.349 | 42.6±7.5 | 47.6±8.1 | <0.001 |
BMI (kg/m2) | 23.2±2.4 | 25.6±2.3 | <0.001 | 21.5±2.5 | 25.3±3.1 | <0.001 |
Fat percentage (%) | 20.4±4.5 | 24.8±4.5 | <0.001 | 28.1±5.1 | 34.7±4.8 | <0.001 |
SBP (mmHg) | 113.0±12.3 | 116.0±12.5 | <0.001 | 105.6±13.5 | 113.8±15.9 | <0.001 |
DBP (mmHg) | 74.1±8.8 | 75.6±8.9 | 0.010 | 67.9±9.3 | 73.0±10.4 | <0.001 |
Glucose (mg/dL) | 95.0 [89.0, 101.0] | 97.0 [91.3, 106.0] | <0.001 | 90.0 [85.0, 95.0] | 96.0 [91.0, 104.0] | <0.001 |
HOMA-IR | 1.2 [0.8, 1.8] | 1.9 [1.3, 2.5] | <0.001 | 1.4 [1.0, 1.9] | 2.2 [1.6, 3.0] | <0.001 |
hsCRP (mg/dL) | 0.04 [0.02, 0.09] | 0.07 [0.04, 0.13] | 0.173 | 0.03 [0.01, 0.06] | 0.08 [0.04, 0.16] | <0.001 |
Obesity | 132 (23.1) | 256 (59.0) | <0.001 | 267 (8.7) | 219 (49.1) | <0.001 |
Hypertension | 121 (21.2) | 134 (30.9) | <0.001 | 226 (7.3) | 93 (20.9) | <0.001 |
Diabetes | 41 (7.2) | 61 (14.1) | <0.001 | 25 (0.8) | 46 (10.3) | <0.001 |
Dyslipidemia history | 98 (17.1) | 104 (24.0) | 0.009 | 138 (4.5) | 58 (13.0) | <0.001 |
Vigorous physical activity (≥3 times/wk) | 142 (24.8) | 74 (17.1) | 0.008 | 643 (20.8) | 87 (19.5) | 0.701 |
Current smoker | 163 (28.5) | 125 (28.8) | 1.000 | 643 (20.8) | 87 (19.5) | 0.701 |
Alcohol consumption (≥1 unit/d) | 310 (54.2) | 227 (52.3) | 0.595 | 61 (2.0) | 9 (2.0) | 1.000 |
Values are presented as mean±standard deviation or median [interquartile range], or number (%).
NALFD, non-alcoholic fatty liver disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein.
1 Continuous data were tested with independent t-test and categorical data were tested with chi-square or Fisher's exact test.
Subjects | BMI (kg/m2) | Presence of NAFLD at baseline | No. of subjects | Person-years | No. of incident cases | Incidence rate per 1000 person-years | RR (95% CI) |
---|---|---|---|---|---|---|---|
Total | <23.0 | Yes | 149 | 370.8 | 19 | 51.2 | 1.08 (0.68, 1.71) |
No | 2612 | 7720.9 | 367 | 47.5 | |||
≥23.0 | Yes | 731 | 2048.5 | 68 | 33.2 | 0.70 (0.53, 0.93)* | |
No | 1044 | 3214.0 | 152 | 47.3 | |||
Male | <23.0 | Yes | 47 | 107.5 | 4 | 37.2 | 1.07 (0.37, 3.14) |
No | 260 | 577.0 | 20 | 34.7 | |||
≥23.0 | Yes | 387 | 970.5 | 21 | 21.6 | 0.95 (0.51, 1.77) | |
No | 312 | 834.7 | 19 | 22.8 | |||
Female | <23.0 | Yes | 102 | 263.3 | 15 | 57.0 | 1.17 (0.70, 1.97) |
No | 2352 | 7143.9 | 347 | 48.6 | |||
≥23.0 | Yes | 344 | 1078.0 | 47 | 43.6 | 0.78 (0.56, 1.09) | |
No | 732 | 2379.3 | 133 | 55.9 |
NAFLD | Model 1 | Model 2 | Model 3 | Model 4 |
---|---|---|---|---|
No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Yes | 0.65 (0.51, 0.82)* | 0.78 (0.61, 1.01) | 0.83 (0.64, 1.08) | 0.84 (0.65, 1.10) |
Values are presented as adjusted hazard ratio (95% confidence interval).
NAFLD, non-alcoholic fatty liver disease; BMI, body mass index; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein.
1 Model 1: adjusted for age, sex; Model 2: adjusted for age, sex, BMI; Model 3: adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP; Model 4: model 3 + adjusted for current smoking status, alcohol intake, vigorous physical activity.
* p<0.05.
Subgroups | No. incident cases |
NAFLD, aHR (95% CI) |
p for interaction | |
---|---|---|---|---|
No | Yes | |||
Age (y)1 | 0.332 | |||
<50 (n = 3376) | 362 | 1.00 (reference) | 0.81 (0.54, 1.22) | |
≥50 (n = 1160) | 244 | 1.00 (reference) | 0.83 (0.58, 1.18) | |
Sex2 | 0.192 | |||
Male (n = 1006) | 64 | 1.00 (reference) | 0.93 (0.52, 1.66) | |
Female (n = 3530) | 542 | 1.00 (reference) | 0.73 (0.54, 0.99)* | |
Menopause3 | 0.844 | |||
Premenopausal female (n = 2795) | 311 | 1.00 (reference) | 0.72 (0.44, 1.20) | |
Postmenopausal female (n = 735) | 231 | 1.00 (reference) | 0.79 (0.54, 1.15) | |
BMI (kg/m2) subgroups I4 | 0.220 | |||
<23.0 (n = 2761) | 386 | 1.00 (reference) | 1.09 (0.67, 1.78) | |
≥23.0 (n = 1775) | 220 | 1.00 (reference) | 0.79 (0.58, 1.03) | |
BMI (kg/m2) subgroups II4 | 0.637 | |||
<23.0 (n = 2761) | 386 | 1.00 (reference) | 1.09 (0.67, 1.78) | |
23.0-24.9 (n = 901) | 129 | 1.00 (reference) | 0.69 (0.43, 1.09) | |
≥25.0 (n = 874) | 91 | 1.00 (reference) | 0.98 (0.62, 1.54) | |
Body fat percentage5 | 0.034 | |||
Q1 (n = 1097) | 145 | 1.00 (reference) | 0.42 (0.09, 1.98) | |
Q2 (n = 1094) | 138 | 1.00 (reference) | 1.28 (0.66, 2.50) | |
Q3 (n = 1097) | 147 | 1.00 (reference) | 0.65 (0.38, 1.10) | |
Q4 (n = 1097) | 123 | 1.00 (reference) | 0.83 (0.54, 1.26) |
NAFLD, non-alcoholic fatty liver disease; aHR, adjusted hazard ratio; CI, confidence interval; BMI, body mass index; Q, quartile; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein.
1 Aadjusted for sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.
2 Adjusted for age, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.
3 Adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.
4 Adjusted for age, sex, body fat percentage, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.
5 Adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.
* p<0.05.
Characteristics | Male |
Female |
||||
---|---|---|---|---|---|---|
Presence of NAFLD at baseline |
p-value |
Presence of NAFLD at baseline |
p-value |
|||
No (n=572) | Yes (n=434) | No (n=3084) | Yes (n=446) | |||
Age (y) | 49.0±10.2 | 49.6±9.3 | 0.349 | 42.6±7.5 | 47.6±8.1 | <0.001 |
BMI (kg/m2) | 23.2±2.4 | 25.6±2.3 | <0.001 | 21.5±2.5 | 25.3±3.1 | <0.001 |
Fat percentage (%) | 20.4±4.5 | 24.8±4.5 | <0.001 | 28.1±5.1 | 34.7±4.8 | <0.001 |
SBP (mmHg) | 113.0±12.3 | 116.0±12.5 | <0.001 | 105.6±13.5 | 113.8±15.9 | <0.001 |
DBP (mmHg) | 74.1±8.8 | 75.6±8.9 | 0.010 | 67.9±9.3 | 73.0±10.4 | <0.001 |
Glucose (mg/dL) | 95.0 [89.0, 101.0] | 97.0 [91.3, 106.0] | <0.001 | 90.0 [85.0, 95.0] | 96.0 [91.0, 104.0] | <0.001 |
HOMA-IR | 1.2 [0.8, 1.8] | 1.9 [1.3, 2.5] | <0.001 | 1.4 [1.0, 1.9] | 2.2 [1.6, 3.0] | <0.001 |
hsCRP (mg/dL) | 0.04 [0.02, 0.09] | 0.07 [0.04, 0.13] | 0.173 | 0.03 [0.01, 0.06] | 0.08 [0.04, 0.16] | <0.001 |
Obesity | 132 (23.1) | 256 (59.0) | <0.001 | 267 (8.7) | 219 (49.1) | <0.001 |
Hypertension | 121 (21.2) | 134 (30.9) | <0.001 | 226 (7.3) | 93 (20.9) | <0.001 |
Diabetes | 41 (7.2) | 61 (14.1) | <0.001 | 25 (0.8) | 46 (10.3) | <0.001 |
Dyslipidemia history | 98 (17.1) | 104 (24.0) | 0.009 | 138 (4.5) | 58 (13.0) | <0.001 |
Vigorous physical activity (≥3 times/wk) | 142 (24.8) | 74 (17.1) | 0.008 | 643 (20.8) | 87 (19.5) | 0.701 |
Current smoker | 163 (28.5) | 125 (28.8) | 1.000 | 643 (20.8) | 87 (19.5) | 0.701 |
Alcohol consumption (≥1 unit/d) | 310 (54.2) | 227 (52.3) | 0.595 | 61 (2.0) | 9 (2.0) | 1.000 |
Subjects | BMI (kg/m2) | Presence of NAFLD at baseline | No. of subjects | Person-years | No. of incident cases | Incidence rate per 1000 person-years | RR (95% CI) |
---|---|---|---|---|---|---|---|
Total | <23.0 | Yes | 149 | 370.8 | 19 | 51.2 | 1.08 (0.68, 1.71) |
No | 2612 | 7720.9 | 367 | 47.5 | |||
≥23.0 | Yes | 731 | 2048.5 | 68 | 33.2 | 0.70 (0.53, 0.93) |
|
No | 1044 | 3214.0 | 152 | 47.3 | |||
Male | <23.0 | Yes | 47 | 107.5 | 4 | 37.2 | 1.07 (0.37, 3.14) |
No | 260 | 577.0 | 20 | 34.7 | |||
≥23.0 | Yes | 387 | 970.5 | 21 | 21.6 | 0.95 (0.51, 1.77) | |
No | 312 | 834.7 | 19 | 22.8 | |||
Female | <23.0 | Yes | 102 | 263.3 | 15 | 57.0 | 1.17 (0.70, 1.97) |
No | 2352 | 7143.9 | 347 | 48.6 | |||
≥23.0 | Yes | 344 | 1078.0 | 47 | 43.6 | 0.78 (0.56, 1.09) | |
No | 732 | 2379.3 | 133 | 55.9 |
NAFLD | Model 1 | Model 2 | Model 3 | Model 4 |
---|---|---|---|---|
No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Yes | 0.65 (0.51, 0.82) |
0.78 (0.61, 1.01) | 0.83 (0.64, 1.08) | 0.84 (0.65, 1.10) |
Subgroups | No. incident cases | NAFLD, aHR (95% CI) |
p for interaction | |
---|---|---|---|---|
No | Yes | |||
Age (y) |
0.332 | |||
<50 (n = 3376) | 362 | 1.00 (reference) | 0.81 (0.54, 1.22) | |
≥50 (n = 1160) | 244 | 1.00 (reference) | 0.83 (0.58, 1.18) | |
Sex |
0.192 | |||
Male (n = 1006) | 64 | 1.00 (reference) | 0.93 (0.52, 1.66) | |
Female (n = 3530) | 542 | 1.00 (reference) | 0.73 (0.54, 0.99) |
|
Menopause |
0.844 | |||
Premenopausal female (n = 2795) | 311 | 1.00 (reference) | 0.72 (0.44, 1.20) | |
Postmenopausal female (n = 735) | 231 | 1.00 (reference) | 0.79 (0.54, 1.15) | |
BMI (kg/m2) subgroups I |
0.220 | |||
<23.0 (n = 2761) | 386 | 1.00 (reference) | 1.09 (0.67, 1.78) | |
≥23.0 (n = 1775) | 220 | 1.00 (reference) | 0.79 (0.58, 1.03) | |
BMI (kg/m2) subgroups II |
0.637 | |||
<23.0 (n = 2761) | 386 | 1.00 (reference) | 1.09 (0.67, 1.78) | |
23.0-24.9 (n = 901) | 129 | 1.00 (reference) | 0.69 (0.43, 1.09) | |
≥25.0 (n = 874) | 91 | 1.00 (reference) | 0.98 (0.62, 1.54) | |
Body fat percentage |
0.034 | |||
Q1 (n = 1097) | 145 | 1.00 (reference) | 0.42 (0.09, 1.98) | |
Q2 (n = 1094) | 138 | 1.00 (reference) | 1.28 (0.66, 2.50) | |
Q3 (n = 1097) | 147 | 1.00 (reference) | 0.65 (0.38, 1.10) | |
Q4 (n = 1097) | 123 | 1.00 (reference) | 0.83 (0.54, 1.26) |
Values are presented as mean±standard deviation or median [interquartile range], or number (%). NALFD, non-alcoholic fatty liver disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein. Continuous data were tested with independent
BMI, body mass index; NAFLD, non-alcoholic fatty liver disease; RR, rate ratio; CI, confidence interval.
Values are presented as adjusted hazard ratio (95% confidence interval). NAFLD, non-alcoholic fatty liver disease; BMI, body mass index; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein. Model 1: adjusted for age, sex; Model 2: adjusted for age, sex, BMI; Model 3: adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP; Model 4: model 3 + adjusted for current smoking status, alcohol intake, vigorous physical activity.
NAFLD, non-alcoholic fatty liver disease; aHR, adjusted hazard ratio; CI, confidence interval; BMI, body mass index; Q, quartile; HOMA-IR, homeostatic model assessment for insulin resistance; hsCRP, high-sensitivity C-reactive protein. Aadjusted for sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity. Adjusted for age, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity. Adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity. Adjusted for age, sex, body fat percentage, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity. Adjusted for age, sex, BMI, hypertension, diabetes, history of dyslipidemia, HOMA-IR, hsCRP, current smoking status, alcohol intake, vigorous physical activity.