Body mass index (BMI) is associated with
fatty liver risk, however, the dose-response relationship between continuous BMI changes and
fatty liver risk has not been clearly defined. In this study, a cross-sectional study was conducted and a total of 3202 individuals were included. Unconditional logistic regression and restricted cubic spline model were used to analyze the dose-response association of BMI with
fatty liver risk. After adjusting for confounding factors (age, gender,
hypertension, total
cholesterol,
triglycerides,
glucose,
high-density lipoprotein,
low-density lipoprotein,
uric acid,
homocysteine,
creatinine,
aspartate aminotransferase and
alanine transaminase),
overweight (OR = 3.55, 95% CI: 2.49-5.06, P = 2.79 × 10-12),
obesity (OR = 7.59, 95% CI: 4.91-11.71, P = 6.56 × 10-20) were significantly related to
fatty liver risk. Stratified by gender (male/female), age (<50 years/≥50 years), prevalence of
hypertension (yes/no), the above association was still significant (P = 0.004 or lower). In dose-response analysis, BMI was statistically significantly associated with
fatty liver risk in a nonlinear fashion (approximately J-shaped fashion, Pnonlinearity = 1.71 × 10-4 or lower) in the total population and all subgroups mentioned above. Findings from this dose-response analysis suggest that higher BMI (
overweight/
obesity) is an independent, dose-dependent risk factor for
fatty liver, and prevention of
fatty liver focusing on continuous changes in BMI should be noted.