title: Predictors for incidence and remission of NAFLD in the general population during a seven-year prospective follow-up.
abstract: OBJECTIVE
  Data on the incidence and remission rates of non-alcoholic fatty liver disease (NAFLD) as well as predictive factors are scant. This study aims at evaluating NAFLD's epidemiology in prospective follow-up of individuals sampled from the general population.
  
  
  METHODS
  Evaluation of metabolic parameters and ultrasonographic evidence of NAFLD was performed in 213 subjects, with no known liver disease or history of alcohol abuse. The evaluation was performed at baseline and after a 7-year period by identical protocols.
  
  
  RESULTS
  Of the 147 patients who did not have NAFLD at baseline, 28 (19%) were found to have NAFLD at a 7-year follow-up. Baseline BMI, HOMA score, blood cholesterol, triglycerides, leptin levels, and weight gain (5.8±6.1 vs. 1.4±5.5kg, p<0.001) were significantly higher and adiponectin was lower among those who developed NAFLD at 7-year follow-up, compared with those who remained NAFLD-free. However, only weight gain and baseline HOMA were independent predictors for the development of NAFLD. Of the 66 patients who were found to have NAFLD at baseline, as many as 24 patients (36.4%) had no evidence of NAFLD at 7years. Weight loss of 2.7±5.0kg was significantly associated with NAFLD remission. Moreover, there was a 75% remission rate among NAFLD patients who lost 5% or more from their baseline weight.
  
  
  CONCLUSIONS
  Among the general population, weight gain, and baseline insulin resistance are predictors for NAFLD incidence. One third of NAFLD patients may have remission of disease within a 7-year follow-up, mostly depending on modest weight reduction.
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel; School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. Electronic address: zelbersagi@bezeqint.net.
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Lotan
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Shlomai
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel.
authors.forename: Muriel
authors.initials: M
authors.lastname: Webb
authors.affiliation: School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Harrari
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Assaf
authors.initials: A
authors.lastname: Buch
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Dorit
authors.initials: D
authors.lastname: Nitzan Kaluski
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.affiliation: Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Oren
mesh_terms: D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology