PloS one · 2019
Modeling the natural history of fatty liver using lifestyle-related risk factors: Effects of body mass index (BMI) on the life-course of fatty liver.
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Aizawa Mika, Inagaki Seiichi, Moriyama Michiko, Asano Kenichiro, Kakehashi Masayuki
Аннотация
BACKGROUND: Incident fatty liver increases the risk of non-alcoholic fatty liver disease (NAFLD), which may lead to end-stage liver diseases, and increase the risk of cardiovascular disease and diabetes. For its prevention, modeling the natural history of fatty liver is useful to demonstrate which lifestyle-related risk factors (e.g. body mass index and cholesterol) play the greatest role in the life-course of fatty liver.
METHODS: Model predictors and their predictive algorithms were determined by prospective regression analyses using 5-year data from approximately 2000 Japanese men aged 20-69 years. The participants underwent health examinations and completed questionnaires on their lifestyle behaviors annually from 2012 to 2016. The life-course of fatty liver was simulated based on this participant data using Monte Carlo simulation methods. Sensitivity analyses were performed. The validity of the model was discussed.
RESULTS: The body mass index (BMI) and low-density/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio significantly aided in predicting incident fatty liver. When the natural history of fatty liver was simulated using the data of participants aged 30-39 years, the prevalence increased from 20% to 32% at 40-59 years before decreasing to 24% at 70-79 years. When annual updates of BMI and LDL-C/HDL-C ratio decreased/increased by 1%, the peak prevalence of fatty liver (32%) changed by -8.0/10.7% and -1.6/1.4%, respectively.
CONCLUSIONS: We modeled the natural history of fatty liver for adult Japanese men. The model includes BMI and LDL‒C/HDL‒C ratio, which played a significant role in predicting the presence of fatty liver. Specifically, annual changes in BMI of individuals more strongly affected the life‒course of fatty liver than those in the LDL-C/HDL-C ratio. Sustainable BMI control for individuals may be the most effective option for preventing fatty liver in a population.
METHODS: Model predictors and their predictive algorithms were determined by prospective regression analyses using 5-year data from approximately 2000 Japanese men aged 20-69 years. The participants underwent health examinations and completed questionnaires on their lifestyle behaviors annually from 2012 to 2016. The life-course of fatty liver was simulated based on this participant data using Monte Carlo simulation methods. Sensitivity analyses were performed. The validity of the model was discussed.
RESULTS: The body mass index (BMI) and low-density/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio significantly aided in predicting incident fatty liver. When the natural history of fatty liver was simulated using the data of participants aged 30-39 years, the prevalence increased from 20% to 32% at 40-59 years before decreasing to 24% at 70-79 years. When annual updates of BMI and LDL-C/HDL-C ratio decreased/increased by 1%, the peak prevalence of fatty liver (32%) changed by -8.0/10.7% and -1.6/1.4%, respectively.
CONCLUSIONS: We modeled the natural history of fatty liver for adult Japanese men. The model includes BMI and LDL‒C/HDL‒C ratio, which played a significant role in predicting the presence of fatty liver. Specifically, annual changes in BMI of individuals more strongly affected the life‒course of fatty liver than those in the LDL-C/HDL-C ratio. Sustainable BMI control for individuals may be the most effective option for preventing fatty liver in a population.