{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T11:01:42Z","timestamp":1761562902008,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally in tandem with the growing obesity epidemic. However, there is a lack of data on the relationship between historical weight changes 10 years ago and at present on NAFLD prevalence at the population level. Therefore, we sought to evaluate the relationship between weight classes and the prevalence of NAFLD. Methods: Data were used from the United States National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Univariate and multivariate general linear model analyses were used to obtain risk ratio (RR) estimations of NAFLD events. Results: In total, 34,486 individuals were analysed, with those who were lean at both time points as the control group. Overweight (RR: 14.73, 95%CI: 11.94 to 18.18, p &lt; 0.01) or obese (RR: 31.51, 95%CI: 25.30 to 39.25, p &lt; 0.01) individuals at both timepoints were more likely to develop NAFLD. Residual risk exists where previously obese individuals became overweight (RR: 14.72, 95%CI: 12.36 to 17.52, p &lt; 0.01) or lean (RR: 2.46, 95%CI: 1.40 to 4.31, p = 0.02), and previously overweight individuals who became lean (RR 2.24, 95%CI 1.42 to 3.54, p = 0.01) had persistent elevated risk of developing NAFLD despite weight regression. Sensitivity analysis identified that a higher proportion of individuals with regression in weight class were diabetics and Mexican Americans, while fewer African Americans saw weight-class regression. Conclusions: Residual risk exists in patients who lost weight despite the smaller magnitude of effect, and targeted weight reductions should still be used to mitigate the risk of NAFLD at the population level.<\/jats:p>","DOI":"10.3390\/ijerph19169935","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T21:15:05Z","timestamp":1660252505000},"page":"9935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Historical Changes in Weight Classes and the Influence of NAFLD Prevalence: A Population Analysis of 34,486 Individuals"],"prefix":"10.3390","volume":"19","author":[{"given":"Benjamin Kai Yi","family":"Nah","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8297-1569","authenticated-orcid":false,"given":"Cheng Han","family":"Ng","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai En","family":"Chan","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8091-9601","authenticated-orcid":false,"given":"Caitlyn","family":"Tan","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6087-1700","authenticated-orcid":false,"given":"Manik","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55902, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca Wenling","family":"Zeng","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieling","family":"Xiao","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yip Han","family":"Chin","sequence":"additional","affiliation":[{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice X. X.","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"},{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-4537","authenticated-orcid":false,"given":"Yi Ping","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Chee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Neo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National University Hospital, Singapore 119074, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-0430","authenticated-orcid":false,"given":"Nicholas W. S.","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre, National University Hospital, Singapore 119074, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2737-7273","authenticated-orcid":false,"given":"Michael","family":"Tseng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Shadab","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun J.","family":"Sanyal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yock Young","family":"Dan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"},{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Muthiah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore"},{"name":"MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"ref_1","unstructured":"Le, M.H., Yeo, Y.H., Li, X., Li, J., Zou, B., Wu, Y., Ye, Q., Huang, D.Q., Zhao, C., and Zhang, J. 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