Journal of gastroenterology and hepatology · 2025
Individualized Effects of Weight Gain in Adulthood on the Development of MASLD in Japanese Non-Obese Individuals.
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Fukamizo Kaiji, Hagiwara Yasuhiro, Kimura Takeshi, Matsuyama Yutaka
Аннотация
BACKGROUND: This study aimed to estimate the individualized effect of weight change since age 20 on the development of metabolic dysfunction-associated steatotic liver disease (MASLD) in Japanese non-obese individuals. We also assessed the clinical characteristics of high-risk individuals with weight gain.
METHOD: This retrospective cohort study included non-obese individuals who underwent health examinations at St. Luke's International Hospital between 2008 and 2018. We developed a counterfactual prediction model using logistic regression to predict the risk of MASLD onset within 3 years and predicted counterfactual risks for 5 weight change scenarios: (i) weight loss < -3 kg, (ii) weight maintenance: ±3 kg, (iii) 3.1-6 kg gain, (iv) 6.1-9.9 kg gain, and (v) major weight gain ≥ 10 kg. Individualized effects of weight change were estimated using a risk difference scale, with variability assessed through their distributions and forest plots.
RESULTS: A total of 20 886 individuals (64.4% women) were included, and 2016 (9.6%) developed MASLD within 3 years. The counterfactual prediction model showed the average risk difference for major weight gain ≥ 10 kg was 6.6% (median: 5.1%), with individual risk differences varied from 2% to 19% across individuals. Forest plot showed an increased average risk of 5% for men, abdominal obesity, dyslipidemia, hyperuricemia, and high ALT levels.
CONCLUSION: Weight change since age 20 is a significant risk factor for MASLD development in non-obese populations, but its impact varies widely among individuals. Men and individuals with abdominal obesity, dyslipidemia, hyperuricemia, and high ALT levels are particularly susceptible to the effects of weight gain.
METHOD: This retrospective cohort study included non-obese individuals who underwent health examinations at St. Luke's International Hospital between 2008 and 2018. We developed a counterfactual prediction model using logistic regression to predict the risk of MASLD onset within 3 years and predicted counterfactual risks for 5 weight change scenarios: (i) weight loss < -3 kg, (ii) weight maintenance: ±3 kg, (iii) 3.1-6 kg gain, (iv) 6.1-9.9 kg gain, and (v) major weight gain ≥ 10 kg. Individualized effects of weight change were estimated using a risk difference scale, with variability assessed through their distributions and forest plots.
RESULTS: A total of 20 886 individuals (64.4% women) were included, and 2016 (9.6%) developed MASLD within 3 years. The counterfactual prediction model showed the average risk difference for major weight gain ≥ 10 kg was 6.6% (median: 5.1%), with individual risk differences varied from 2% to 19% across individuals. Forest plot showed an increased average risk of 5% for men, abdominal obesity, dyslipidemia, hyperuricemia, and high ALT levels.
CONCLUSION: Weight change since age 20 is a significant risk factor for MASLD development in non-obese populations, but its impact varies widely among individuals. Men and individuals with abdominal obesity, dyslipidemia, hyperuricemia, and high ALT levels are particularly susceptible to the effects of weight gain.