Reply to the letter by Lai et al. regarding “Body mass index is the most useful predictive factor for the onset of nonalcoholic fatty liver disease: a community-based retrospective longitudinal study”

Excerpt

We thank Lai et al. for their letter showing interest in our paper [1]. We agree with their opinion that body mass index (BMI) is useful to identify individuals at risk of developing nonalcoholic fatty liver disease (NAFLD), as well as to predict the presence of NAFLD in primary care settings. Previously, they examined the relationship between NAFLD and cardiovascular risk factors in a hospital-based, cross-sectional study [2]. In this study, they defined generalized obesity as a BMI of at least 27 kg/m² as recommended by the Bureau of Health Promotion, Department of Health, Taiwan [3], and identified male gender, generalized obesity, central obesity, hyperglycemia, hypercholesterolemia, a high level of LDL-C, a low level of HDL-C, and hyperuricemia as the related factors for the presence of NAFLD [2]. Eguchi et al. also reported in a multicenter, large, retrospective study among the general population that BMI was also a useful marker for identifying NAFLD subjects. They showed that BMI in subjects with NAFLD was significantly higher than in those without NAFLD (p < 0.01), and the prevalence of NAFLD showed a linear increase with the increase of BMI (BMI < 23 kg/m², 10.5 %; 23 ≤ BMI < 25 kg/m², 37.9 %; 25 ≤ BMI < 28 kg/m², 58.4 %; BMI ≥ 28 kg/m², 84.2 %) [4]. …