Non-obese NAFLD subjects demonstrate lower risk of metabolic syndrome than obese non-NAFLD subjects: a multicenter cross-sectional study

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) and obesity are risk factors for metabolic syndrome (MetS). Interaction between NAFLD and obesity might deteriorate the probability of MetS. We aim to evaluate the non-obese NAFLD for the risk of MetS compared with obese non-NAFLD. Methods: A population-based cross-sectional study was collected in three different hospitals in Taiwan from 2015 to 2022. Anthropometric and biochemical measurements were collected after 8-hour fasting. NAFLD was diagnosed through abdominal ultrasonography by trained doctors. Participants were divided into two groups by body mass index (BMI) with a 25 kg/m² cutoff value and NAFLD status. The risk of MetS with the status of NAFLD and obesity was assessed using a multiple logistic regression model. Results: 690 eligible participants were involved in the analysis, with 441 non-obese NAFLD and 249 obese non-NAFLD subjects. The mean age was 62.7 ± 16.7 years old. The prevalence of MetS was 35.4% in the non-obese NAFLD group and 47.7% in the obese non-NAFLD group, respectively. The non-obese NAFLD group demonstrates a lower percentage of abnormal waist circumference and blood pressure than the obese non-NAFLD group (p<0.05). However, the ratio of abnormal triglyceride, high-density lipoprotein cholesterol (HDL-C), and glucose were similar between the two groups (p>0.05). The non-obese NAFLD group demonstrates a lower risk of MetS than the obese non-NAFLD group (Odds ratio 0.68, 95% confidence interval [CI]: 0.47-0.97). Conclusions: Both NAFLD and obesity increase the risk of MetS. As a risk factor, NAFLD reveals a lower MetS risk than obesity.