Impacts of smoking on alcoholic liver disease: a nationwide cohort study
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ABSTRACT:
SUBMITTER: Yoo J
PROVIDER: S-EPMC11335641 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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| S-EPMC11234741 | biostudies-literature
Project description:BackgroundStudies suggest an association between osteoporosis and non-alcoholic fatty liver disease (NAFLD), but whether patients with NAFLD are at increased risk of fractures is unknown.ObjectivesThe aim was to determine the rate and risk of fractures and the mortality rate after fracture in patients with NAFLD compared to the general population.MethodsThis was a nationwide population-based cohort study using data from the Swedish National Patient Registry on 10,678 patients with NAFLD from 1987 to 2016. Patients were matched for sex, age, and municipality with 99,176 controls from the Swedish Total Population Registry. Cox regression was used to estimate fracture rates. The risk of fractures was assessed while accounting for competing risks (death and liver transplantation).ResultsA total of 12,312 fractures occurred during 761,176 person-years of follow-up. Patients with NAFLD (17.5 per 1000 person-years) had a slightly higher fracture rate than controls (16.1 per 1000 person-years; adjusted hazard ratio 1.11, 95% confidence interval [CI] 1.05-1.19), although the 5-year risk of fractures was similar (8.0%, 95% CI 7.4-8.6 versus 7.3%, 95% CI 7.2-7.5). Additionally, 1-year mortality after fracture was similar in NAFLD and controls.ConclusionsPatients with NAFLD have a slightly higher rate of fractures but long-term risk of fractures comparable to the general population. This suggests that broad surveillance of risk factors for fractures in patients with NAFLD is not motivated.
| S-EPMC9545244 | biostudies-literature
Project description:BackgroundEvidence for the association between underlying non-alcoholic fatty liver disease (NAFLD), the risk of testing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive, and the clinical consequences of coronavirus disease 2019 (COVID-19) is controversial and scarce. We aimed to investigate the association between the presence of NAFLD and the risk of SARS-CoV-2 infectivity and COVID-19-related outcomes.MethodsWe used the population-based, nationwide cohort in South Korea linked with the general health examination records between January 1, 2018 and July 30, 2020. Data for 212,768 adults older than 20 years who underwent SARS-CoV-2 testing from January 1 to May 30, 2020, were obtained. The presence of NAFLDs was defined using three definitions, namely hepatic steatosis index (HSI), fatty liver index (FLI), and claims-based definition. The outcomes were SARS-CoV-2 test positive, COVID-19 severe illness, and related death.ResultsAmong 74,244 adults who completed the general health examination, there were 2,251 (3.0%) who were SARS-CoV-2 positive, 438 (0.6%) with severe COVID-19 illness, and 45 (0.06%) COVID-19-related deaths. After exposure-driven propensity score matching, patients with pre-existing HSI-NAFLD, FLI-NAFLD, or claims-based NAFLD had an 11-23% increased risk of SARS-CoV-2 infection (HSI-NAFLD 95% confidence interval [CI], 1-28%; FLI-NAFLD 95% CI, 2-27%; and claims-based NAFLD 95% CI, 2-31%) and a 35-41% increased risk of severe COVID-19 illness (HSI-NAFLD 95% CI, 8-83%; FLI-NAFLD 95% CI, 5-71%; and claims-based NAFLD 95% CI, 1-92%). These associations are more evident as liver fibrosis advanced (based on the BARD scoring system). Similar patterns were observed in several sensitivity analyses including the full-unmatched cohort.ConclusionPatients with pre-existing NAFLDs have a higher likelihood of testing SARS-CoV-2 positive and severe COVID-19 illness; this association was more evident in patients with NAFLD with advanced fibrosis. Our results suggest that extra attention should be given to the management of patients with NAFLD during the COVID-19 pandemic.
| S-EPMC8546310 | biostudies-literature
Project description:ObjectiveTo evaluate the association between non-alcoholic fatty liver disease and all cause and cause specific mortality in a representative sample of the US general population.DesignProspective cohort study.SettingUS Third National Health and Nutrition Examination Survey (NHANES III: 1988-94) with follow-up of mortality to 2006.Participants11,371 adults aged 20-74 participating in the Third National Health and Nutrition Examination Survey, with assessment of hepatic steatosis.Main outcome measureMortality from all causes, cardiovascular disease, cancer, and liver disease (up to 18 years of follow-up).ResultsThe prevalence of non-alcoholic fatty liver disease with and without increased levels of liver enzymes in the population was 3.1% and 16.4%, respectively. Compared with participants without steatosis, those with non-alcoholic fatty liver disease but normal liver enzyme levels had multivariate adjusted hazard ratios for deaths from all causes of 0.92 (95% confidence interval 0.78 to 1.09), from cardiovascular disease of 0.86 (0.67 to 1.12), from cancer of 0.92 (0.67 to 1.27), and from liver disease of 0.64 (0.12 to 3.59). Compared with participants without steatosis, those with non-alcoholic fatty liver disease and increased liver enzyme levels had adjusted hazard ratios for deaths from all causes of 0.80 (0.52 to 1.22), from cardiovascular disease of 0.59 (0.29 to 1.20), from cancer of 0.53 (0.26 to 1.10), and from liver disease of 1.17 (0.15 to 8.93).ConclusionsNon-alcoholic fatty liver disease was not associated with an increased risk of death from all causes, cardiovascular disease, cancer, or liver disease.
| S-EPMC3220620 | biostudies-literature
Project description:PurposeThe Trivandrum non-alcoholic fatty liver disease (NAFLD) cohort is a population-based study designed to examine the interaction between genetic and lifestyle factors and their association with increased risk of NAFLD within the Indian population.ParticipantsBetween 2013 and 2016, a total of 2222 participants were recruited to this cohort through multistage cluster sampling across the whole population of Trivandrum-a district within the state of Kerala, South India. Data were collected from all inhabitants of randomly selected households over the age of 25.Findings to dateFull baseline clinical and pathological data were collected from 2158 participants. This included detailed demographic profiles, anthropometric measures and lifestyle data (food frequency, physical activity and anxiety and depression questionnaires). Biochemical profile and ultrasound assessment of the liver were performed and whole blood aliquots were collected for DNA analysis.The NAFLD prevalence within this population was 49.8% which is significantly higher than the global pooled prevalence of 25%. This highlights the importance of robust, prospective studies like this to enable collection of longitudinal data on risk factors, disease progression and to facilitate future interventional studies.Future plansThe complete analysis of data collected from this cohort will give valuable insights into the interaction of the phenotypic and genotypic profiles that result in such a dramatic increased risk of NAFLD within the Indian population. The cohort will also form the basis of future lifestyle interventional studies, aimed at improving liver and metabolic health.
| S-EPMC6502065 | biostudies-literature
Project description:Non-alcoholic fatty liver disease (NAFLD) and smoking have similar mechanisms of promoting colorectal polyps. The potential link between NAFLD and smoking in men and colorectal polyps has not been adequately evaluated. The aim is to investigate this association.A retrospective cross-sectional study was conducted on 2409 individuals undergoing a health check. Univariate and multivariate logistic regression were performed for analyzing the association between risk factors and colorectal polyps. Individuals were divided into four groups: Q1: NAFLD (-)/smoking (-); Q2: NAFLD (+)/smoking (-); Q3: NAFLD (-)/smoking (+); Q4: NAFLD (+)/smoking (+). Logistic analyses were used to explore associations for the whole study population and stratified groups.The prevalence of colorectal polyps was 38.8% in males, and that of colorectal polyps in smokers and individuals with NAFLD were 47.0% (428/911) and 42.9% (267/622), respectively. With Q1 as reference, subjects with NAFLD (+) and smoking habits (+) had the highest ORs for colorectal polyps (OR = 2.64, 95% CI: 1.91 - 3.64, P < 0.001), adenomatous polyps (OR = 2.06, 95% CI: 1.38 - 3.05, P < 0.05), non-adenomatous polyps (OR = 1.97, 95% CI: 1.39 - 2.80, P < 0.05), ? 3 polyps (OR = 2.05, 95% CI: 1.31 - 3.22, P < 0.05) and proximal polyps (OR = 1.58, 95% CI: 1.02 - 2.45, P < 0.05) after adjusting for confounding variables.Men with NAFLD and smoking habits have an increasing risk of colorectal polyps.
| S-EPMC5650390 | biostudies-literature
Project description:PurposeThis study investigated whether alcoholic intoxication (AI) increases the risk of inflammatory bowel disease (IBD) by using a population-based database in Taiwan.MethodsThis retrospective matched-cohort study included 57 611 inpatients with new-onset AI (AI cohort) and 230 444 randomly selected controls (non-AI cohort). Each patient was monitored for 10 years to individually identify those who were subsequently diagnosed with Crohn disease (CD) and ulcerative colitis (UC) during the follow-up period. Cox proportional hazard regression analysis was conducted to determine the risk of IBD in patients with AI compared with controls without AI.ResultsThe incidence rate of IBD during the 10-year follow-up period was 2.69 per 1 000 person-years and 0.49 per 1 000 person-years in the AI and non-AI cohorts, respectively. After adjustment for age, sex, and comorbidity, the AI cohort exhibited a 3.17-fold increased risk of IBD compared with the non-AI cohort (hazard ratio [HR] = 3.17, 95% confidence interval [CI] = 2.19-4.58). Compared with the non-AI cohort, the HRs of CD and UC were 4.40 and 2.33 for the AI cohort, respectively. After stratification for the severity of AI according to the duration of hospital stay, the adjusted HRs exhibited a significant correlation with the severity; the HRs of IBD were 1.76, 6.83, and 19.9 for patients with mild, moderate, and severe AI, respectively (p for the trend < .0001).ConclusionThe risk of IBD was higher in patients with AI and increased with the length of hospital stay.
| S-EPMC5089729 | biostudies-literature
Project description:Although both liver and muscle are metabolically active endocrine organs, and non-alcoholic fatty liver disease (NAFLD) and sarcopenia may share common pathogenic determinants, there have been few clinical studies of the relationship between NAFLD and muscle strength, especially in the elderly. We conducted a nationally representative population-based, cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, which involved 1,897 men aged ≥50 years and 2,206 postmenopausal women. NAFLD was defined using the hepatic steatosis index (HSI) and low muscle strength was defined using the Korea-specific cut-off point of hand grip strength (HGS). Men and women with NAFLD had 7.3% and 7.9% lower HGS than controls, respectively. The odds ratios for low muscle strength in the presence of NAFLD were 2.51 in men and 2.34 in women. HSI inversely correlated with HGS in both men and women. Consistently, compared with men and women in the lowest HSI quartile, those in the highest quartile had 7.6% and 12.4% lower HGS, respectively, and were 5.63- and 3.58-times more likely to have low muscle strength, respectively. These results provide the first clinical evidence that NAFLD can be associated with muscular impairment in older adults, as demonstrated by lower muscle strength.
| S-EPMC6660042 | biostudies-literature
Project description:BackgroundRemnant cholesterol (RC) is an emerging non-traditional risk factor for cardiovascular diseases that has garnered increasing attention. In addition, non-alcoholic fatty liver disease (NAFLD) may interact synergistically with RC. This study aimed to evaluate the association between RC and functional outcomes in ischemic stroke patients and to investigate the potential interaction effect between RC and NAFLD.MethodsThis study utilized data from the Third China National Stroke Registry (CNSR-III), which includes ischemic stroke patients monitored for 3 months post-stroke onset. RC was calculated by subtracting both low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) from total cholesterol. Poor functional outcomes were defined as a modified Rankin Scale (mRS) score of 3-6 at the 3-month follow-up. Multivariable logistic regression analyses were conducted to determine the association between RC and functional outcomes. Interaction effect analysis was performed to investigate how NAFLD modifies the relationship between RC and prognosis.ResultsAmong the 7, 234 participants, the mean age was 62.96 ± 11.44 years and 4,572 (63.2%) were male individuals. Compared to the lowest quartile of RC (Q1), the highest quartile of the RC (Q4) was associated with a lower risk of poor functional outcomes (OR: 0.98, 95% CI: 0.96-1.00). Meanwhile, we observed a similar relationship between RC and poor functional outcomes in patients with NAFLD (OR: 0.96, 95% CI: 0.93-0.99); however, in those without NAFLD, there was no significant association between RC and poor functional outcomes.ConclusionWe found an inverse relationship between RC levels and poor functional outcomes in patients with ischemic stroke, which was influenced by NAFLD. Future studies are needed to determine the optimal target levels of RC in NAFLD patients.
| S-EPMC11822771 | biostudies-literature
Project description:Although self-rated health (SRH), a subjective measure of overall health status, associates with metabolic abnormalities, studies on the relationship between SRH and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, are limited. In this study, we evaluated whether or not SRH predicts the risk of incident NAFLD. This cohort study was performed in a sample of 148,313 Korean adults free of ultrasound-diagnosed NAFLD at baseline with annual or biennial follow-up for a median of 3.7 years. SRH and NAFLD were measured at baseline and follow-up visits. NAFLD was determined based on the ultrasound-diagnosed fatty liver without excessive alcohol consumption or any other cause. Hazard ratios with 95% confidence intervals were estimated via a parametric proportional hazards model. During 522,696.1 person-years of follow-up, 23,855 individuals with new-onset NAFLD were identified (incidence rate, 45.6 per 1,000 person-years). After adjustments for possible confounders including total calorie intake, sleep duration, and depressive symptoms, the multivariate-adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing good, fair, and poor or very poor SRH to very good SRH were 1.06 (0.97-1.14), 1.18 (1.09-1.27), and 1.24 (1.13-1.37), respectively. This association of SRH with incident NAFLD remained significant after accounting for changes in SRH and confounders during follow-up and was similar across clinically relevant subgroups. In a large-scale cohort study of apparently healthy Korean adults, poor SRH was independently and positively associated with incident NAFLD risk, indicating a predictive role of SRH as a health measure in NAFLD.
| S-EPMC7052149 | biostudies-literature