ArticleThe American journal of gastroenterology2016
Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease.
Article in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06491342 (PROBIOTIC SUPPLEMENT VERSUS PLACEBO FOR DECREASE STEATOSIS IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE), which is not on this map. Cited by 118 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Probiotic supplement versus placebo for decrease steatosis in metabolic dysfunction-associated steatotic liver disease (masld): a multicenter, randomized, double-blind, placebo-controlled trial
Who cites it
118 citing papers in PubMed, 3 syntheses or guidelines pooled it, 210 citations in OpenAlex.
- Risk factors for hepatocellular carcinoma: an umbrella review of systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease.Clinical and molecular hepatology · 2021Guideline
- Association between nonalcoholic fatty liver disease and extrahepatic cancers: a systematic review and meta-analysis.Lipids in health and disease · 2020Pooled it
- The Effect of Zinc Supplementation on Steatosis Severity and Liver Function Enzymes in Overweight/Obese Patients with Mild to Moderate Non-alcoholic Fatty Liver Following Calorie-Restricted Diet: a Double-Blind, Randomized Placebo-Controlled Trial.Biological trace element research · 2020Trial
- Dietary index for gut microbiota, plasma metabolome, and risks of metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases.Nutrition & metabolism · 2026Article
- Cross-Sectional Associations of Metabolically Healthy Obesity, Lifestyle Factors, and Steatotic Liver Disease in Adults from the Fels Longitudinal Study.Metabolites · 2026Article
- Critical role of interleukin-33 in pathogenesis and progression of metabolic dysfunction-associated steatotic liver disease.Frontiers in medicine · 2026Review
- Time-updated FIB-4 index predicts coronary artery calcification progression in individuals with metabolic dysfunction-associated steatotic liver disease.Scientific reports · 2025Article
- Liver fibrosis index and mortality in metabolic dysfunction-associated steatotic liver disease: a Korean cohort study.Scientific reports · 2025Article
- Metabolically healthy obesity increases the risks of MASLD and hyperuricemia: a cohort study with mediation analysis.BMC endocrine disorders · 2025Article
- Impact of Change, Fluctuation, or Variability in Weight on the Risk of Nonalcoholic Fatty Liver Disease in General Population: A Systematic Review and Meta-Analysis.Health science reports · 2025Article
- Metabolically Healthy Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Navigating the Controversies in Disease Development and Progression.Current obesity reports · 2025Review
- Prevalence and association of MASLD in metabolically healthy young Asian Americans with obesity: A nationwide inpatient perspective (2019).Obesity pillars · 2025Article
- KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025.Clinical and molecular hepatology · 2025Article
- FIB-4: A screening tool for advanced liver fibrosis in a cohort of subjects participating in a primary care weight-loss program.PloS one · 2025Article
- Article
- Prevalence, risk factors and association with gallstone disease of non-alcoholic fatty liver disease among rural indigenous communities: A cross-sectional study in Sarawak, Malaysia.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2025Article
- Evolving epidemiology of non-alcoholic fatty liver disease in South Korea: incidence, prevalence, progression, and healthcare implications from 2010 to 2022.The Korean journal of internal medicine · 2024Article
- High-density lipoprotein cholesterol trajectory and new-onset metabolic dysfunction-associated fatty liver disease incidence: a longitudinal study.Diabetology & metabolic syndrome · 2024Article
- Genetic associations of birthweight, childhood, and adult BMI with metabolic dysfunction-associated steatotic liver disease: a Mendelian randomization.BMC gastroenterology · 2024Article
58 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe risk of nonalcoholic fatty liver disease (NAFLD) among obese individuals without obesity-related metabolic abnormalities, a condition referred to as metabolically healthy obese (MHO), is largely unexplored. Therefore, we examined the association between body mass index (BMI) categories and the development of NAFLD in a large cohort of metabolically healthy men and women.
methodsA cohort study was conducted in 77,425 men and women free of NAFLD and metabolic abnormalities at baseline, who were followed-up annually or biennially for an average of 4.5 years. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance <2.5. The presence of fatty liver was determined using ultrasound.
resultsDuring 348,193.5 person-years of follow-up, 10,340 participants developed NAFLD (incidence rate, 29.7 per 1,000 person-years). The multivariable adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing overweight and obese with normal-weight participants were 2.15 (2.06-2.26) and 3.55 (3.37-3.74), respectively. In detailed dose-response analyses, increasing baseline BMI showed a strong and approximately linear relationship with the incidence of NAFLD, with no threshold at no risk. This association was present in both men and women, although it was stronger in women (P for interaction <0.001), and it was evident in all clinically relevant subgroups evaluated, including participants with low inflammation status.
conclusionsIn a large cohort of strictly defined metabolically healthy men and women, overweight and obesity were strongly and progressively associated with an increased incidence of NAFLD, suggesting that the obese phenotype per se, regardless of metabolic abnormalities, can increase the risk of NAFLD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.