Differences of lifestyle behaviors between non-obese and obese non-alcoholic fatty liver disease; beyond visceral obesity and metabolic syndrome

Background and Aims: Best way to treat non-alcoholic fatty liver disease (NAFLD) is weight reduction. bu However, strategy of lifestyle modification in non-obese NAFLD patient is unclear. The aim of study was to investigate differences of lifestyle behaviors between non-obese and obese non-alcoholic fatty liver disease. Methods: This study has been performed with 209 patients who wanted to participate in nutrition education program because of their abnormal liver enzyme or fatty liver. All participants undertook computed tomography. NAFLD was diagnosed when liver/spleen Hounsfield Unit (HU) was less than 1.1. Five day food record and physical activity was measured by two dietitians. Results: Prevalence of NAFLD was significantly higher as 66.1 % in obese subjects (BMI>25) than 42.4% in normal weight (BMI≤25) (p = 0.001). Non-obese NAFLD group showed higher visceral fat area, aminotrans-ferase activity, and fasting glucose compare to normal liver/ spleen HU subjects. In univariate analysis, non-obese NAFLD group showed higher carbohydrate intake (281 g/dayvs. 246 g/day), and did lower moderate level exercise compare to control group (p = 0.013). But total calorie intake (1,955 Kcal vs. 1,837 Kcal) and walking time/week were not difference. In multivariate analysis, the amount of carbohydrate (p = 0.018) and more than 2 hours of exercise a week (p = 0.010) were risk factors for NAFLD independent with visceral fat area and total calorie intake. Meanwhile fasting glucose (p < 0.001), the amount of fat intake (p = 0.006) and visceral fat area (p = 0.008) were independent risk factor for NAFLD in obese subjects (BMI >25). Conclusions: The moderate level exercise of 2 hours a week and the amount of carbohydrate intake were independent risk factor in non-obese NAFLD patients. Disclosures: The following authors have nothing to disclose: Joo Hee Kwak, Dae Won Jun, Seung Min Lee, Yong Kyun Cho, Eun Chul Jan