{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:04:31Z","timestamp":1792202671440,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Obesity and metabolic conditions may be related to non\u2010alcoholic fatty liver disease (NAFLD). The study assesses the risk of NAFLD according to obesity and metabolic health status in a community\u2010based population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1651 subjects were recruited from the community. Individuals were categorized into four groups according to obesity status (defined as a body mass index\u00a0\u2265\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>) and metabolically healthy status: metabolically healthy nonobesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy nonobesity (MUHNO), and metabolically unhealthy obesity (MUHO). NAFLD was diagnosed based on a semiquantitative ultrasonography measurement. Visceral fat was assessed through bioelectrical impedance analysis and is shown by tertile (T1, T2, and T3). A proportional odds model was used to assess the cumulative risk of NAFLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The NAFLD prevalence was 26.7%, 62.8%, 47.0%, and 76.7% in subjects with MHNO, MHO, MUHNO, and MUHO, respectively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). After adjustment for age, sex, exercise habits, alcohol consumption, cigarette smoking, and visceral fat, the odds ratios for more severe NAFLD were 2.44 (95% confidence interval [CI]: 1.64\u20133.65), 2.75 (95% CI: 1.91\u20133.94), and 7.41 (95% CI: 4.94\u201311.12) in the MHO, MUHNO, and MUHO groups, respectively, compared with the MHNO group. In addition, the odds ratios for more severe NAFLD significantly increased with the increase in visceral fat level (T2 <jats:italic>vs<\/jats:italic> T1: 3.83, 95% CI: 2.65\u20135.53; T3 <jats:italic>vs<\/jats:italic> T1: 9.17, 95% CI: 5.33\u201315.79).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both obesity and metabolically unhealthy status were associated with a higher risk of NAFLD independent of visceral fat level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15544","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T06:36:41Z","timestamp":1620715001000},"page":"2903-2910","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Metabolically healthy obesity and risk of non\u2010alcoholic fatty liver disease severity independent of visceral fat"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-2573","authenticated-orcid":false,"given":"Tsung\u2010Po","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Community and Family Medicine China Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Yuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine China Medical University Hospital  Taichung Taiwan"},{"name":"Department of Social Medicine, College of Medicine China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Hsieh","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting\u2010Hsin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine China Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo\u2010Chin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Family Medicine, College of Medicine National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0047-2238","authenticated-orcid":false,"given":"Kuen\u2010Cheh","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine National Taiwan University  Taipei 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