Longitudinal analysis of risk of Non-Alcoholic Fatty Liver Disease (NAFLD) in adulthood

Abstract

<div>Background and aims: Childhood overweight/obesity, not metabolic health, is associated with increased risk for adult non-alcoholic fatty liver disease. However, the increased risk associated with childhood overweight/obesity can be largely removed by obtaining a normal body mass index by adulthood. <br></div><div><br></div><div>Methods: We aimed to determine how childhood body mass index (BMI) and metabolic health, along with change in BMI between childhood and adulthood, determine the risk of adult non-alcoholic fatty liver disease (NAFLD).</div><div><br></div><div>Results: Data from 2,020 participants aged 3-18 years at baseline, followed up 31 years later, was examined to assess the utility of four childhood metabolic phenotypes (metabolic groups I: normal BMI, no metabolic disturbances; II: normal BMI, one or more metabolic disturbances; III: overweight/obese, no metabolic disturbances; IV: overweight/obese, one or more metabolic disturbances) and four life-course adiposity phenotypes (adiposity group 1: normal child and adult BMI; 2, high child, normal adult BMI; 3, normal child BMI, high adult BMI; 4, high child and adult BMI) in predicting adult NAFLD.</div><div><br></div><div>Conclusion: The risk for adult NAFLD was similar across all four groups after adjustment for age, sex, lifestyle factors and adult BMI. Risk of adult NAFLD was not increased among individuals overweight/obese in childhood but non-obese in adulthood. In contrast, overweight or obese adults, irrespective of their youth BMI status, had ~8-10 fold increased risk (P<0.001).</div>