A nationwide survey of the association between nonalcoholic fatty liver disease and the incidence of asthma in Korean adults.

Jae-Hyung Roh,Bae Yun-Jeong,Chan Sun Park,Hyo-Jung Kim,Hanbyul Lee,Sun-Young Yoon,Huei-Kai Huang

doi:10.1371/journal.pone.0262715

Jae-Hyung Roh, Bae Yun-Jeong + Show 5 more

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https://doi.org/10.1371/journal.pone.0262715

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Abstract

BackgroundAsthma and nonalcoholic fatty liver disease (NAFLD) are chronic diseases known to be associated with metabolic abnormalities. We aimed to clarify the association between NAFLD and asthma incidence in a large population-based cohort.Methods and findingsWe selected 160,603 individuals without comorbidities from the National Health Insurance Service-National Sample cohort between 2009 and 2014. NAFLD was defined using a surrogate marker, fatty liver index (FLI). During a median of 5.08 years’ follow-up, 16,377 subjects (10.2%) were newly diagnosed with asthma and categorized into three groups according to FLI. The cumulative incidence of asthma was higher in subjects with higher vs. lower FLIs (FLI < 30, 10.1%; 30 ≤ FLI < 60, 10.8%; FLI ≥ 60, 10.5%). Higher FLI was associated with an increased incidence of asthma (Hazard ratios (HR)highest vs. lowest FLI, 1.25; 95% CI, 1.15–1.36). The results using another definition of NAFLD, as measured by the hepatic steatosis index (HSI), were similar to the primary results. This association was more pronounced in women than in men (HR 1.46; 95% CI, 1.13–1.64 vs. HR 1.07; 95% CI, 0.94–1.20).ConclusionsThis study demonstrated that NAFLD, as measured by FLI and HSI, may influence the incidence rates of asthma in adults, especially in women.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and its prevalence in Asian-Pacific countries is estimated to be 20%–30% [1,2].NAFLD is associated with an increase in multisystem diseases, including diabetes, ischemic cardiovascular disease, and chronic kidney disease [3,4]
Asthma and nonalcoholic fatty liver disease (NAFLD) are chronic diseases known to be associated with metabolic abnormalities
This study demonstrated that NAFLD, as measured by fatty liver index (FLI) and hepatic steatosis index (HSI), may influence the incidence rates of asthma in adults, especially in women

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and its prevalence in Asian-Pacific countries is estimated to be 20%–30% [1,2].NAFLD is associated with an increase in multisystem diseases, including diabetes, ischemic cardiovascular disease, and chronic kidney disease [3,4]. Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and its prevalence in Asian-Pacific countries is estimated to be 20%–30% [1,2]. An association between NAFLD and atrial fibrillation, a non-ischemic cardiac disease, has been reported [5]. Asthma is the most common chronic airway disease, with approximately 350 million cases reported worldwide in 2015 [6]. Recent studies have reported the epidemiological link between metabolic syndrome (MetS) and asthma. Several studies have reported the association of asthma with other components of MetS, such as dyslipidemia and insulin resistance, as well as obesity [9,10,11]. Asthma and nonalcoholic fatty liver disease (NAFLD) are chronic diseases known to be associated with metabolic abnormalities. We aimed to clarify the association between NAFLD and asthma incidence in a large population-based cohort.

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