Nonobese NAFLD subjects demonstrate lower risk of metabolic syndrome than obese non-NAFLD subjects: A multicenter cross-sectional study

Nonalcoholic fatty liver disease (NAFLD) and obesity are risk factors for metabolic syndrome (MetS). Interaction between NAFLD and obesity might deteriorate the probability of MetS. We aim to evaluate the nonobese NAFLD for the risk of MetS compared with obese non-NAFLD. A population-based cross-sectional study was collected in 3 different hospitals in Taiwan from 2015 to 2022. Anthropometric and biochemical measurements were collected after 8-hour fasting. NAFLD was diagnosed through abdominal ultrasonography by trained doctors. Participants were divided into 2 groups by body mass index with a 25 kg/m2 cutoff value and NAFLD status. The risk of MetS with the status of NAFLD and obesity was assessed using a multiple logistic regression model. Six hundred ninety eligible participants were involved in the analysis, with 441 nonobese NAFLD and 249 obese non-NAFLD subjects. The mean age was 62.7 ± 16.7 years old. The prevalence of MetS was 35.4% in the nonobese NAFLD group and 47.7% in the obese non-NAFLD group, respectively. The nonobese NAFLD group demonstrates a lower percentage of abnormal waist circumference and blood pressure than the obese non-NAFLD group (P < .05). However, the ratio of abnormal triglyceride, high-density lipoprotein cholesterol, and glucose were similar between the 2 groups (P > .05). The nonobese NAFLD group demonstrates a lower risk of MetS than the obese non-NAFLD group (odds ratio 0.68, 95% confidence interval: 0.47-0.97). Both NAFLD and obesity increase the risk of MetS. As a risk factor, NAFLD reveals a lower MetS risk than obesity.