Uchit Thapa, MBBS1, Harshith Thyagaturu, MD1, Samir Jha, MD2, Navalok Sharma Ghimire, MBBS1, Parikshya Giri Rijal, MBBS1, Lintha Shah, MBBS1, Amna Shaukat, MBBS1, Anish Paudel, MD3, Hira Hanif, MD4, Prakash Poudel Jaishi, MBBS5, Suravi Khanal, MBBS6, Aashish K. Singh, MBBS7 1Bassett Medical Center, Cooperstown, NY; 2Beth Israel Deaconess Medical Center, Boston, MA; 3Reading Hospital Tower Health, West Reading, PA; 4Reading Tower Health, West Reading, PA; 5Al Kamil Health Center, Al Kamil, Janub ash Sharqiyah, Oman; 6Manipal College of Medical Sciences, Pokhara, Gandaki, Nepal; 7APPL, Nongpoh, Meghalaya, India
Introduction: NAFLD has been historically associated with obesity but was recently found to have an association with lean individuals as well. We thereby conducted a nationwide study to identify the prevalence of NAFLD in different BMI categories and their association with mortality.
Methods: We queried the 2019 NIS database to identify all adult ( >18 years) patients with NAFLD using appropriate ICD-10-CM codes. We categorized BMI into category I (19.9 or less), category II (20-24.9), category III (25-29.9), category IV (30-34.9), category V (35-39.9), and category VI (> 40) using appropriate ICD-10-CM codes. An univariate screen followed by multivariate logistic regression was performed to adjust for potential hospital and patient level confounders. Stata 17.0 software was used to perform all statistical analyses.
Results: A total of 532,485 NAFLD patients were identified which corresponds to 1.5% of the total US hospitalizations in the year 2019. Of which, 7,964 (1.5%) were category I, 7,530 (1.4%) were category II, 13,450 (2.5%) were category III, 36,650 (6.8%) were category IV, 42,715 (8%) were category V, and 94,425 (17.7%) were category VI. On multivariate analysis, we found that category I NAFLD patients had increased odds of mortality compared to other BMI subgroups [OR 1.71 (1.3-2.2); p< 0.001].
Discussion: Obesity has been linked with the development of NAFLD. As expected, our study demonstrated an increasing prevalence of NAFLD with higher BMI. However, we found that 2.9% of NAFLD patients were not obese. This group of patients had been termed “lean NAFLD”. The hypothesis for lean NAFLD is poorly understood with theories including higher bile production and genetic variations. Interestingly, we found that category I NAFLD patients had higher odds of mortality compared to other BMI groups. These findings could be a result of lean individuals suffering chronic medical conditions or certain malignancies and is beyond the scope of our study. Further studies regarding etiologies for lean NAFLD might bring clarity to this subject.
Disclosures:
Uchit Thapa indicated no relevant financial relationships.
Harshith Thyagaturu indicated no relevant financial relationships.
Samir Jha indicated no relevant financial relationships.
Navalok Sharma Ghimire indicated no relevant financial relationships.
Parikshya Giri Rijal indicated no relevant financial relationships.
Lintha Shah indicated no relevant financial relationships.
Amna Shaukat indicated no relevant financial relationships.
Anish Paudel indicated no relevant financial relationships.
Hira Hanif indicated no relevant financial relationships.
Prakash Poudel Jaishi indicated no relevant financial relationships.
Suravi Khanal indicated no relevant financial relationships.
Aashish Singh indicated no relevant financial relationships.
Uchit Thapa, MBBS1, Harshith Thyagaturu, MD1, Samir Jha, MD2, Navalok Sharma Ghimire, MBBS1, Parikshya Giri Rijal, MBBS1, Lintha Shah, MBBS1, Amna Shaukat, MBBS1, Anish Paudel, MD3, Hira Hanif, MD4, Prakash Poudel Jaishi, MBBS5, Suravi Khanal, MBBS6, Aashish K. Singh, MBBS7. C0500 - NAFLD Prevalence in BMI Subclass and Outcomes in 2019, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.