Abstract

Backgrounds: Depression and anxiety disorder are frequently seen in patients with nonalcoholic fatty liver disease (NAFLD). However, the associations between mood disorders and NAFLD have not been fully evaluated. In this study, we investigated the relationship between NAFLD and depression or anxiety in a Korean population.Methods: We conducted a retrospective cross-sectional study that included subjects who underwent abdominal ultrasonography and completed a symptom questionnaire for a routine health check-up. NAFLD was diagnosed and graded according to the ultrasonography findings. Depression and anxiety were assessed using the Beck Depression Inventory and State-Trait Anxiety Inventory, respectively.Results: Among the total of 25,333 subjects, the mean age was 47 years (men, 56.2%), and the prevalence rate of NAFLD was 30.9%. In the multivariate analysis, NAFLD showed a significant association with depression [adjusted odds ratio (OR) 1.43 and 95% confidence interval (CI) 1.14–1.80, p = 0.002] in women. Severe NAFLD significantly correlated with state anxiety and trait anxiety (adjusted OR 1.84 and 95% CI 1.01–3.37, p = 0.047 and adjusted OR 2.45 and 95% CI 1.08–4.85, p = 0.018, respectively) in women.Conclusions: There was a higher tendency of women with NAFLD to suffer from depression with increase in steatosis, and severe stage of steatosis was significantly associated with anxiety in the female compared to non-NAFLD. Understanding the association between NAFLD and mood disorders may have clinical implications for reducing the prevalence of comorbidities.

Highlights

  • Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, with increasing prevalence of up to 20–30% [1]

  • NAFLD showed a significant association with depression [adjusted odds ratio (OR) 1.43 and 95% confidence interval (CI) 1.14–1.80, p = 0.002] in women

  • Severe NAFLD significantly correlated with state anxiety and trait anxiety in women

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Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, with increasing prevalence of up to 20–30% [1]. NAFLD has been associated with an increased prevalence of psychological conditions such as depression and anxiety. A previous study reported that the prevalence rates of lifetime major depressive disorder (MDD) and generalized anxiety disorder were more increased in patients with NASH with more advanced histological features compared to controls [7]. Generalized anxiety disorder is one of the most common anxiety disorders [15], and anxiety disorder is associated with hyperglycemia in patients with diabetes [16]. This result suggests that there is a close link between anxiety and metabolic disease

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