Daniel J Cuthbertson1, Emily Brown1, Juha Koskinen2,3, Costan G Magnussen2,4, Nina Hutri-Kähönen5, Matthew Sabin6,7, Päivi Tossavainen8, Eero Jokinen9, Tomi Laitinen10, Jorma Viikari11,12, Olli T Raitakari2, Markus Juonala6,11,12. 1. Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. 2. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 3. Heart Center, Kymenlaakson keskussairaala, Kotka, Finland. 4. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. 5. Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland. 6. Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 7. The Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia. 8. Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland. 9. Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. 10. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. 11. Department of Medicine, University of Turku, Turku, Finland. 12. Division of Medicine, Turku University Hospital, Turku, Finland.
Abstract
BACKGROUND & AIMS: We aimed to determine how childhood body mass index and metabolic health, along with the change in body mass index between childhood and adulthood, determine the risk of adult non-alcoholic fatty liver disease. METHODS: Data from 2020 participants aged 3-18 years at baseline, followed up 31 years later, were examined to assess the utility of four childhood metabolic phenotypes (Metabolic Groups I: normal body mass index, no metabolic disturbances; II: normal body mass index, one or more metabolic disturbances; III: overweight/obese, no metabolic disturbances; IV: overweight/obese, one or more metabolic disturbances) and four life-course adiposity phenotypes (Adiposity Group 1: normal child and adult body mass index; 2, high child, normal adult body mass index; 3, normal child body mass index, high adult body mass index; 4, high child and adult body mass index) in predicting adult non-alcoholic fatty liver disease. RESULTS: The risk for adult non-alcoholic fatty liver disease was similar across all four groups after adjustment for age, sex, lifestyle factors and adult body mass index. Risk of adult non-alcoholic fatty liver disease was not increased among individuals overweight/obese in childhood but non-obese in adulthood. In contrast, overweight or obese adults, irrespective of their youth body mass index status, had ~eight-fold to 10-fold increased risk (P < 0.001). CONCLUSIONS: Childhood overweight/obesity, not metabolic health, is associated with increased risk for adult non-alcoholic fatty liver disease. However, the increased risk associated with childhood overweight/obesity can be largely removed by obtaining a normal body mass index by adulthood.
BACKGROUND & AIMS: We aimed to determine how childhood body mass index and metabolic health, along with the change in body mass index between childhood and adulthood, determine the risk of adult non-alcoholic fatty liver disease. METHODS: Data from 2020 participants aged 3-18 years at baseline, followed up 31 years later, were examined to assess the utility of four childhood metabolic phenotypes (Metabolic Groups I: normal body mass index, no metabolic disturbances; II: normal body mass index, one or more metabolic disturbances; III: overweight/obese, no metabolic disturbances; IV: overweight/obese, one or more metabolic disturbances) and four life-course adiposity phenotypes (Adiposity Group 1: normal child and adult body mass index; 2, high child, normal adult body mass index; 3, normal child body mass index, high adult body mass index; 4, high child and adult body mass index) in predicting adult non-alcoholic fatty liver disease. RESULTS: The risk for adult non-alcoholic fatty liver disease was similar across all four groups after adjustment for age, sex, lifestyle factors and adult body mass index. Risk of adult non-alcoholic fatty liver disease was not increased among individuals overweight/obese in childhood but non-obese in adulthood. In contrast, overweight or obese adults, irrespective of their youth body mass index status, had ~eight-fold to 10-fold increased risk (P < 0.001). CONCLUSIONS: Childhood overweight/obesity, not metabolic health, is associated with increased risk for adult non-alcoholic fatty liver disease. However, the increased risk associated with childhood overweight/obesity can be largely removed by obtaining a normal body mass index by adulthood.