The Association Between Different Obesity Phenotypes and Liver Fibrosis Scores in Elderly Individuals with Fatty Liver in Taiwan

Abstract

Purpose: To examine the association between different phenotypes of obesity or metabolic syndromes and liver fibrosis score in a Taiwanese elderly population with fatty liver. Patients and Methods: This cross-sectional study included 1817 participants aged ≥65 years with fatty liver diagnosed by sonography. We used ethnicity-specific criteria for body mass index and metabolic syndrome, and to define obesity phenotypes as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Correlated fibrosis severity was calculated using the nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) and Fibrosis-4 (FIB-4). Fibrosis severity was divided into two categories according to NFS (no-to-mild fibrosis and advanced fibrosis, defined as NFS ≤ 0.676 and >0.676, respectively) and FIB-4 score (no-to-mild fibrosis and advanced fibrosis, defined as FIB-4 score ≤2.67 and >2.67, respectively). Results: Compared with that in the MHNO group, the associated risk (odds ratio [OR], 95% confidence interval [CI]) of advanced fibrosis by NFS was 2.43 (1.50-3.93), 2.35 (1.25-4.41), and 6.11 (3.90-9.59), whereas that of advanced fibrosis by FIB-4 score was 1.34 (0.83-2.18), 2.37 (1.36-4.13), and 1.38 (0.82-2.31) in the MUNO, MHO, and MUO groups, respectively. Conclusion: Both metabolic syndrome and obesity were positively associated with more advanced fibrosis according to NFS. The detrimental effect of obesity appears to be more than metabolic abnormalities per se in the elderly with more advanced fibrosis severity according to the FIB-4 score.

Association between obesity phenotypes and non-alcoholic fatty liver: a large population- based study

“…A study by Kuang et al (2022) demonstrated that both the metabolically healthy/abdominal obesity and metabolically unhealthy/ abdominal obesity phenotypes were closely associated with an increased risk of NAFLD in both sexes [35]. Lee The authors concluded that obesity alone has more deleterious effects than metabolic disorders on the severity of advanced fibrosis, and these effects were greater in women than in men [36]. These findings are consistent with the results of this study.…”

Lean non-alcoholic fatty liver disease (Lean-NAFLD) and the development of metabolic syndrome: a retrospective study

“…Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver disease 1 , 2 , and also an emerging risk factor for type 2 diabetes mellitus, cardiovascular disease, renal diseases and all-cause mortality 3 . The prevalence of NAFLD is reported to be approximately 25% worldwide 4 , ranges from 24.0 to 46.0% in western industrialized countries and from 7.9 to 54.0% in Asian countries 5 , 6 . As obesity is a major risk of NAFLD, the prevalence of NAFLD is expected to continue rising paralleled with the global epidemic of obesity 6 , 7 ,especially in China where obesity has increased at an estimated annual rate of 0.32%.…”

“…The prevalence of NAFLD is reported to be approximately 25% worldwide 4 , ranges from 24.0 to 46.0% in western industrialized countries and from 7.9 to 54.0% in Asian countries 5 , 6 . As obesity is a major risk of NAFLD, the prevalence of NAFLD is expected to continue rising paralleled with the global epidemic of obesity 6 , 7 ,especially in China where obesity has increased at an estimated annual rate of 0.32%.…”

Ferroptosis and metabolic dysfunction‐associated fatty liver disease: Is there a link?

“…Previous studies have shown that MAFLD is closely related to obesity, and ferroptosis might further promote the development of MAFLD by affecting obesity. 39,40 Experimentally, it has been reported that iron-chelating agents (e.g. deferoxamine, deferiprone or deferasirox) have the potential to treat obesity.…”