title: Body Mass Index and Risk of Nonalcoholic Fatty Liver Disease: Two Electronic Health Record Prospective Studies.
abstract: BACKGROUND
  The relationship between rising body mass index (BMI) and prospective risk of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is virtually absent.
  
  
  OBJECTIVE
  Determine the extent of the association between BMI and risk of future NAFLD diagnosis, stratifying by sex and diabetes.
  
  
  METHODS
  Two prospective studies using Humedica and Health Improvement Network (THIN) with 1.54 and 4.96 years of follow-up, respectively.
  
  
  METHODS
  Electronic health record databases.
  
  
  METHODS
  Patients with a recorded BMI measurement between 15 and 60 kg/m(2), and smoking status, and 1 year of active status before baseline BMI. Patients with a diagnosis or history of chronic diseases were excluded.
  
  
  METHODS
  None.
  
  
  METHODS
  Recorded diagnosis of NAFLD/NASH during follow-up (Humedica International Classification of Diseases, Ninth Revision code 571.8, and read codes for NAFLD and NASH in THIN).
  
  
  RESULTS
  Hazard ratios (HRs) were calculated across BMI categories using BMI of 20-22.5 kg/m(2) as the reference category, adjusting for age, sex, and smoking status. Risk of recorded NAFLD/NASH increased linearly with BMI and was approximately 5-fold higher in Humedica (HR = 4.78; 95% confidence interval, 4.17-5.47) and 9-fold higher in THIN (HR = 8.93; 7.11-11.23) at a BMI of 30-32.5 kg/m(2) rising to around 10-fold higher in Humedica (HR = 9.80; 8.49-11.32) and 14-fold higher in THIN (HR = 14.32; 11.04-18.57) in the 37.5- to 40-kg/m(2) BMI category. Risk of NAFLD/NASH was approximately 50% higher in men and approximately double in those with diabetes.
  
  
  CONCLUSIONS
  These data quantify the consistent and strong relationships between BMI and prospectively recorded diagnoses of NAFLD/NASH and emphasize the importance of weight reduction strategies for prevention and management of NAFLD.
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: A Katrina
authors.initials: AK
authors.lastname: Loomis
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Shaum
authors.initials: S
authors.lastname: Kabadi
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: David
authors.initials: D
authors.lastname: Preiss
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Craig
authors.initials: C
authors.lastname: Hyde
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Vinicius
authors.initials: V
authors.lastname: Bonato
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Matthew
authors.initials: M
authors.lastname: St Louis
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Jigar
authors.initials: J
authors.lastname: Desai
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Jason M R
authors.initials: JM
authors.lastname: Gill
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Paul
authors.initials: P
authors.lastname: Welsh
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Dawn
authors.initials: D
authors.lastname: Waterworth
authors.affiliation: Pfizer Worldwide Research and Development (A.K.L., S.K., C.H., V.B., M.S.L., J.D.), Groton, Connecticut 06340-5159, and Pfizer Worldwide Research and Development, New York, New York 10017; British Heart Foundation Glasgow Cardiovascular Research Centre (D.P., J.M.R.G., P.W., N.S.), University of Glasgow, Glasgow G12 8TA, United Kingdom; and Cardiovascular, Metabolic and Dermatology Genetics Unit (D.W.), GlaxoSmithKline, King of Prussia, Pennsylvania 19406.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
mesh_terms: D000328:Adult; D015992:Body Mass Index; D048909:Diabetes Complications / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology