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We investigated the effects of body components and subsequent changes on incident NAFLD at follow-up ultrasound scanning in a longitudinal cohort. We included 9967 participants without NAFLD at baseline who underwent serial health examinations. Sex-specific, weight-adjusted skeletal muscle index (SMI<jats:sub>_Wt<\/jats:sub>) was used. Mean follow-up duration was 48.5\u2009\u00b1\u200933.5\u00a0months. NAFLD developed in 2395 participants (24.0%). Body composition was measured using bioelectrical impedance analysis. The following baseline body components were significantly associated with incident NAFLD: the lowest and middle SMI<jats:sub>_Wt<\/jats:sub> tertiles in the normal-weight group (adjusted hazard ratio [aHR]\u2009=\u20092.20 and 1.54, respectively), and fat percentage in the normal-weight (aHR\u2009=\u20091.12), overweight (aHR\u2009=\u20091.05), and obese groups (aHR\u2009=\u20091.03) (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Among 5,033 participants who underwent\u2009\u2265\u20093 health examinations, SMI<jats:sub>_Wt<\/jats:sub> increase between the first and second examinations was an independent protective factor against incident NAFLD in non-obese groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Increased fat percentage was an independent risk factor for incident NAFLD in all weight categories (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). High fat mass at baseline may be a better predictor of incident NAFLD than muscle mass. Reciprocal changes in fat and muscle mass during the first year of follow-up predicted incident NAFLD in non-obese groups.<\/jats:p>","DOI":"10.1038\/s41598-020-74659-9","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T10:04:27Z","timestamp":1602756267000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Relative fat mass at baseline and its early change may be a predictor of incident nonalcoholic fatty liver disease"],"prefix":"10.1038","volume":"10","author":[{"given":"Hwi Young","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Jung","family":"Baik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Ah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byoung Kwon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Hun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwon","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"74659_CR1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/hep.28431","volume":"64","author":"ZM Younossi","year":"2016","unstructured":"Younossi, Z. 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