High fat in blood and body and increased risk of clinically diagnosed non-alcoholic fatty liver disease in 105,981 individuals

High-caloric diets rich in fat and/or carbohydrates lead to increased fat accumulation in adipose tissue [1,2]. Following saturation of the fat deposits in adipose tissue, storage of fat continues in ectopic fat deposits around internal organs and in the liver [3]. Continued caloric overconsumption together with adipose tissue saturation also results in an altered plasma lipid profile, as seen by increased plasma triglycerides, that is, excess amount of fat in the blood [1]. Put simply, increased caloric intake leads to increased fat in blood and body, likely leading to increased fat in the liver. Thus, increased body mass index (BMI) and waist circumference indicating increased body fat, and increased plasma triglycerides indicating increased blood fat, individually and combined, are likely to be indicative of a future diagnosis of non-alcoholic fatty liver disease.

Few studies have examined this scenario prospectively. In a study of 3215 individuals, higher BMI was associated with increased risk of developing non-alcoholic fatty liver disease; however, that study took neither waist circumference nor plasma triglycerides into account [4]. In another study of 2307 individuals, higher BMI was associated with non-alcoholic fatty liver disease while higher plasma triglycerides were only associated with non-alcoholic fatty liver disease in non-obese individuals with BMI <25 kg/m2 [5].

We tested the hypothesis that baseline high plasma triglycerides, BMI, and waist circumference individually and combined are associated with clinically diagnosed non-alcoholic fatty liver disease during follow-up. For this purpose, we studied 105,981 asymptomatic individuals from the Copenhagen General Population Study and followed them for up to 15 years for development of clinically diagnosed non-alcoholic fatty liver disease.

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