Associations between combinations of body mass index plus non-alcoholic fatty liver disease and diabetes mellitus among Korean adults.

The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories plus non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus (DM) among Korean adults. We prepared the data of 5665 subjects aged 20 years and over who had visited a health promotion center. We excluded 582 subjects as they had a viral or alcoholic liver disease. According to BMI-NAFLD status, the subjects were categorized as non-obese (BMI<25 kg/m2) without NAFLD (n=2568), obese (BMI≥25 kg/m2) without NAFLD (n=572), non-obese with NAFLD (n=748), or obese with NAFLD (n=1195). The prevalence of NAFLD was highest in the obese subjects with DM (87.9%). In non-obese and non-DM subjects, the prevalence of NAFLD was lowest (18.4%). After adjustment of age, gender, waist circumference, smoking status, alcohol drinking, regular exercise, the odd ratios for DM or DM plus impaired fasting glucose (IFG) of subjects with mild NAFLD regardless of obesity were almost 2-fold compared to non-obese subjects without NAFLD. Moreover, those of subjects with moderate or severe NAFLD regardless of obesity were about 4- fold. Clinicians and investigators need to pay attention to non-obese patients with fatty liver.