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Abstract
We investigated the association between body weight variability and the risks of cardiovascular disease and mortality in patients with nonalcoholic fatty liver disease (NAFLD) using large-scale, nationwide cohort data. We included 726,736 individuals with NAFLD who underwent a health examination between 2009 and 2010. NAFLD was defined as a fatty liver index ≥ 60, after excluding significant alcohol intake, viral hepatitis, and liver cirrhosis. Body weight variability was assessed using four indices, including variability independent of the mean (VIM). During a median 8.1-year follow-up, we documented 11,358, 14,714, and 22,164 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively. Body weight variability was associated with an increased risk of MI, stroke, and mortality after adjusting for confounding variables. The hazard ratios (HRs) (95% confidence intervals) for the highest quartile, compared with the lowest quartile, of VIM for body weight were 1.15 (1.10–1.20), 1.22 (1.18–1.26), and 1.56 (1.53–1.62) for MI, stroke, and all-cause mortality, respectively. Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in NAFLD patients. Appropriate interventions to maintain a stable weight could positively affect health outcomes in NAFLD patients.
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1 CHA University School of Medicine, Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Republic of Korea (GRID:grid.410886.3) (ISNI:0000 0004 0647 3511); Clinical and Translational Hepatology Laboratory, Seongnam, Republic of Korea (GRID:grid.410886.3)
2 Soongsil University, Department of Statistics and Actuarial Science, Seoul, Republic of Korea (GRID:grid.263765.3) (ISNI:0000 0004 0533 3568)
3 The Catholic University of Korea, Department of Biomedicine and Health Science, Seoul, Republic of Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
4 CHA University School of Medicine, Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Republic of Korea (GRID:grid.410886.3) (ISNI:0000 0004 0647 3511)
5 Massachusetts General Hospital and Harvard Medical School, Clinical and Translational Epidemiology Unit, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Massachusetts General Hospital and Harvard Medical School, Division of Gastroenterology, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Massachusetts General Hospital and Harvard Medical School, Liver Center, Division of Gastroenterology, Department of Medicine, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
6 Massachusetts General Hospital and Harvard Medical School, Clinical and Translational Epidemiology Unit, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Massachusetts General Hospital and Harvard Medical School, Division of Gastroenterology, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)