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Background and Aim: The aim of this study was to assess the impact of body mass index (BMI) on the clinical and histological characteristics of patients with nonalcoholic fatty liver disease (NAFLD). Methods: Patients with clinically diagnosed NAFLD who received liver biopsy were retrospectively enrolled from 2007 to 2019. For comparison, all of the patients were divided into lean body mass (< 23 kg/m2), overweight (23–24.9 kg/m2), and obesity (BMI ≧ 25 kg/m2). Results: A total of 572 patients with histologically confirmed NAFLD, including 40 (6.99%) lean body mass, 54 (9.44%) overweight, and 478 (83.57%) obese patients, were recruited. Obese NAFLD patients had significantly higher grade of steatosis (grade 3: 29.92% vs 22.22% vs 12.5%, P < 0.0001) and hepatocyte ballooning (grade 2: 14.85% vs 12.96% vs 12.5%, P < 0.0001) than overweight and lean NAFLD patients. The prevalence of nonalcoholic steatohepatitis (NASH) was 22.5%, 25.93%, and 36.19% in lean, overweight, and obese NAFLD patients, respectively. Obesity was significantly associated with fibrosis severity (P = 0.03). The fibrosis index based on four factors (FIB‐4) score can identify NAFLD patients without significant fibrosis or with cirrhosis. The areas under the receiver‐operating characteristic curve of FIB‐4 score to identify patients without significant fibrosis or with cirrhosis were 0.82 (95% confidence interval [CI]: 0.69–0.96) and 0.87 (95% CI: 0.76–0.99) in lean patients; 0.77 (95% CI: 0.61–0.93) and 0.81 (95% CI: 0.59–1.0) in overweight patients; and 0.77 (95% CI: 0.72–0.82) and 0.89 (95% CI: 0.85–0.92) in obese patients. Conclusions: The majority of NAFLD patients are obese, as defined by BMI. Obesity was significantly associated with NASH and hepatic fibrosis severity in patients with NAFLD. In the present study, we demonstrated that the prevalence of nonalcoholic steatohepatitis (NASH) was higher in obese NAFLD patients than in those with lean and overweight NAFLD. Histologically, obese NAFLD patients had significantly higher grade of steatosis and hepatocyte ballooning than lean and overweight NAFLD patients. Moreover, the fibrosis index based on four factors (FIB‐4) score had good values of area under receiver‐operating characteristic curves to identify NAFLD patients without significant fibrosis or with cirrhosis, irrespective the body mass index. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between visual impairment (VI) and psychological distress (PD) among older adults in Taiwan. The present cohort study included participants aged >65 years who participated in a physical examination program. Participants were divided into two groups on the basis of whether they had PD at baseline. The association between PD and VI with other variables was compared using the two-sample t-test for continuous variables and chi-squared test for discrete variables. Cox regression analyses were used to calculate the hazard ratio (HR). Cumulative incidence of PD was analyzed using the Kaplan-Meier method, and differences among participants with different severities of VI were analyzed using the two-tailed log-rank test. Subgroup analyses were performed to calculate the HR for PD among participants with different severities of VI. The PD group showed a significantly high percentage of VI. In addition, participants with VI showed a significantly higher HR and seven-year cumulative incidence rate of PD than those without VI. VI was independently and significantly associated with a higher incidence of PD among older Asian people. Therefore, identifying and treating correctible VI is important to prevent PD and improve the overall quality of life. [ABSTRACT FROM AUTHOR]