{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:21:52Z","timestamp":1781810512478,"version":"3.54.5"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:p>Nonalcoholic fatty liver disease (NAFLD) is independently associated with obesity and cardiovascular disease (CVD). CVD is the primary cause of mortality in the predominantly obese population of adults with NAFLD. NAFLD is increasingly seen in individuals who are lean and overweight (i.e., nonobese), but it is unclear whether their risk of CVD is comparable to those with NAFLD and obesity. Using a prospective cohort of patients with NAFLD, we compared the prevalence and incidence of CVD in individuals with and without obesity. NAFLD was diagnosed by biopsy or imaging after excluding other chronic liver disease etiologies. Logistic regression was used to compare the odds of baseline CVD by obesity status. Cox proportional hazards regression was used to evaluate obesity as a predictor of incident CVD and to identify predictors of CVD in subjects with and without obesity. At baseline, adults with obesity had a higher prevalence of CVD compared to those without obesity (12.0% vs. 5.0%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02). During follow\u2010up, however, obesity did not predict incident CVD (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.69\u20102.22) or other metabolic diseases. Findings were consistent when considering body mass index as a continuous variable and after excluding subjects who were overweight. Age (adjusted HR [aHR], 1.05; 95% CI, 1.03\u20101.08), smoking (aHR, 4.61; 95% CI, 1.89\u201011.22), and decreased low\u2010density lipoprotein levels (aHR, 0.98; 95% CI, 0.96\u20101.00) independently predicted incident CVD in the entire cohort, in subjects with obesity, and in those without obesity, respectively. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Individuals with overweight or lean NAFLD are not protected from incident CVD compared to those with NAFLD and obesity, although CVD predictors appear to vary between these groups. Patients without obesity also should undergo rigorous risk stratification and treatment.<\/jats:p>","DOI":"10.1002\/hep4.1818","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T10:24:43Z","timestamp":1630578283000},"page":"309-319","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Risk of Cardiovascular Disease in Individuals With Nonobese Nonalcoholic Fatty Liver Disease"],"prefix":"10.1097","volume":"6","author":[{"given":"Ashwini","family":"Arvind","sequence":"first","affiliation":[{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Liver Center and Gastrointestinal Division,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3488-6615","authenticated-orcid":false,"given":"Jacqueline B.","family":"Henson","sequence":"additional","affiliation":[{"name":"Harvard Medical 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Medicine,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arley","family":"Donovan","sequence":"additional","affiliation":[{"name":"Liver Center and Gastrointestinal Division,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwafemi","family":"Balogun","sequence":"additional","affiliation":[{"name":"Liver Center and Gastrointestinal Division,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.","family":"Chung","sequence":"additional","affiliation":[{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Liver Center and Gastrointestinal Division,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Clinical and Translational Epidemiology Unit,Massachusetts General 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