IMPACT OF OBESITY ON DISEASE SEVERITY AND CLINICAL OUTCOMES IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is among the most prevalent chronic liver disorders worldwide and is closely associated with the rising rates of obesity. Excess adiposity contributes to hepatic steatosis, chronic inflammation, insulin resistance, and progressive liver injury, which increase the risk of advanced fibrosis, cirrhosis, and adverse clinical outcomes. While the relationship between obesity and NAFLD is well established, evidence regarding its impact on disease severity and hospital-based clinical outcomes remains limited in many developing healthcare settings.

Objective: This study investigated the impact of obesity on disease severity and clinical outcomes among patients diagnosed with non-alcoholic fatty liver disease in a tertiary care hospital.

Methods: This hospital-based cross-sectional study included 90 adult patients with clinically and radiologically confirmed NAFLD who attended the gastroenterology and hepatology departments of a tertiary healthcare facility. Participants were classified as obese or non-obese according to body mass index (BMI) based on World Health Organization criteria. Demographic information, metabolic risk factors, laboratory results, liver function parameters, imaging findings, and clinical outcomes were collected using structured forms and medical record reviews. Disease severity was assessed using established clinical and radiological indicators, including liver fibrosis staging, hepatic steatosis grade, and liver enzyme abnormalities. Descriptive statistics summarized participant characteristics. Chi-square tests, independent sample t-tests, and multivariable logistic regression analyses were used to assess the association between obesity and disease severity, adjusting for potential confounders. Statistical significance was set at p < 0.05.

Results: Obese patients demonstrated significantly higher rates of moderate-to-severe hepatic steatosis, elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, insulin resistance, hypertension, type 2 diabetes mellitus, and dyslipidemia compared to non-obese patients. Obesity was independently associated with an increased risk of advanced liver fibrosis and less favorable clinical outcomes, including prolonged hospitalization and a greater burden of metabolic complications. Multivariable analysis identified obesity as a significant independent predictor of severe NAFLD after adjustment for age, sex, diabetes, and other metabolic risk factors.

Conclusion: Obesity significantly influences the severity and clinical progression of non-alcoholic fatty liver disease. Patients with obesity exhibit more advanced liver involvement and less favorable clinical outcomes compared to non-obese individuals. These findings underscore the importance of early obesity screening, comprehensive metabolic risk assessment, and multidisciplinary weight management interventions to prevent disease progression and improve outcomes in patients with NAFLD.