Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population
BackgroundNon-alcoholic fatty liver disease (NAFLD), especially lean NAFLD is associated with an increased risk of atherosclerotic cardiovascular disease (CVD). It is not currently known which clinical phenotypes of NAFLD contribute most to individual subclinical atherosclerosis risk. We examined th...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1104859/full |
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| author | Yaqin Wang Ting Yuan Shuwen Deng Xiaoling Zhu Yuling Deng Xuelian Liu Lei Liu Changfa Wang |
| author_facet | Yaqin Wang Ting Yuan Shuwen Deng Xiaoling Zhu Yuling Deng Xuelian Liu Lei Liu Changfa Wang |
| author_sort | Yaqin Wang |
| collection | DOAJ |
| description | BackgroundNon-alcoholic fatty liver disease (NAFLD), especially lean NAFLD is associated with an increased risk of atherosclerotic cardiovascular disease (CVD). It is not currently known which clinical phenotypes of NAFLD contribute most to individual subclinical atherosclerosis risk. We examined the relationship between body mass index (BMI), the metabolically healthy status, and subclinical atherosclerosis in the NAFLD population.MethodsData from asymptomatic NAFLD subjects who participated in a routine health check-up examination were collected. Participants were stratified by BMI (cutoff values: 24.0–27.9 kg/m2 for overweight and ≥28.0 kg/m2 for obesity) and metabolic status, which was defined by Adult Treatment Panel III criteria. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity (baPWV) in 27,738 participants and by carotid plaque in 14,323 participants.ResultsWithin each BMI strata, metabolically unhealthy subjects had a significantly higher prevalence of subclinical atherosclerosis than metabolically healthy subjects, whereas fewer differences were observed across subjects within the same metabolic category. When BMI and metabolic status were assessed together, a metabolically unhealthy status was the main contributor to the association of clinical phenotypes with the subclinical atherosclerosis burden (all p < 0.001). When BMI and metabolic abnormalities were assessed separately, the incidence of subclinical disease did not increase across BMI categories; however, it increased with an increase in the number of metabolic abnormalities (0, 1, 2 and ≥3).ConclusionA metabolically healthy status in NAFLD patients was closely correlated with subclinical atherosclerosis, beyond that of the BMI-based obesity phenotype. The application of metabolic phenotyping strategies could enable more precise classification in evaluating cardiovascular risk in NAFLD. |
| first_indexed | 2024-03-11T23:36:14Z |
| format | Article |
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| language | English |
| last_indexed | 2024-03-11T23:36:14Z |
| publishDate | 2023-09-01 |
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| series | Frontiers in Nutrition |
| spelling | doaj.art-b67380c2160e460fb2fc02cdae168aac2023-09-20T02:51:29ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-09-011010.3389/fnut.2023.11048591104859Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease populationYaqin Wang0Ting Yuan1Shuwen Deng2Xiaoling Zhu3Yuling Deng4Xuelian Liu5Lei Liu6Changfa Wang7Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, ChinaBackgroundNon-alcoholic fatty liver disease (NAFLD), especially lean NAFLD is associated with an increased risk of atherosclerotic cardiovascular disease (CVD). It is not currently known which clinical phenotypes of NAFLD contribute most to individual subclinical atherosclerosis risk. We examined the relationship between body mass index (BMI), the metabolically healthy status, and subclinical atherosclerosis in the NAFLD population.MethodsData from asymptomatic NAFLD subjects who participated in a routine health check-up examination were collected. Participants were stratified by BMI (cutoff values: 24.0–27.9 kg/m2 for overweight and ≥28.0 kg/m2 for obesity) and metabolic status, which was defined by Adult Treatment Panel III criteria. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity (baPWV) in 27,738 participants and by carotid plaque in 14,323 participants.ResultsWithin each BMI strata, metabolically unhealthy subjects had a significantly higher prevalence of subclinical atherosclerosis than metabolically healthy subjects, whereas fewer differences were observed across subjects within the same metabolic category. When BMI and metabolic status were assessed together, a metabolically unhealthy status was the main contributor to the association of clinical phenotypes with the subclinical atherosclerosis burden (all p < 0.001). When BMI and metabolic abnormalities were assessed separately, the incidence of subclinical disease did not increase across BMI categories; however, it increased with an increase in the number of metabolic abnormalities (0, 1, 2 and ≥3).ConclusionA metabolically healthy status in NAFLD patients was closely correlated with subclinical atherosclerosis, beyond that of the BMI-based obesity phenotype. The application of metabolic phenotyping strategies could enable more precise classification in evaluating cardiovascular risk in NAFLD.https://www.frontiersin.org/articles/10.3389/fnut.2023.1104859/fullcross-sectional studymetabolic statusobesity phenotypesubclinical atherosclerosisnon-alcoholic fatty liver disease |
| spellingShingle | Yaqin Wang Ting Yuan Shuwen Deng Xiaoling Zhu Yuling Deng Xuelian Liu Lei Liu Changfa Wang Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population Frontiers in Nutrition cross-sectional study metabolic status obesity phenotype subclinical atherosclerosis non-alcoholic fatty liver disease |
| title | Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population |
| title_full | Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population |
| title_fullStr | Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population |
| title_full_unstemmed | Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population |
| title_short | Metabolic health phenotype better predicts subclinical atherosclerosis than body mass index-based obesity phenotype in the non-alcoholic fatty liver disease population |
| title_sort | metabolic health phenotype better predicts subclinical atherosclerosis than body mass index based obesity phenotype in the non alcoholic fatty liver disease population |
| topic | cross-sectional study metabolic status obesity phenotype subclinical atherosclerosis non-alcoholic fatty liver disease |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1104859/full |
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