Abstract
BackgroundFactors of lifestyle may have a major impact on liver-related morbidity and mortality.We examined independent and joint effects of lifestyle risk factors on fatty liver index (FLI), a biomarker of hepatic steatosis, in a population-based cross-sectional national health survey.MethodsThe study included 12,368 participants (5784 men, 6584 women) aged 25–74 years. Quantitative estimates of alcohol use, smoking, adiposity and physical activity were used to establish a total score of risk factors, with higher scores indicating an unhealthier lifestyle. FLI was calculated based on an algorithm including body mass index, waist circumference, serum gamma-glutamyltransferase and triglycerides.ResultsThe occurrence of FLI ≥ 60% indicating fatty liver increased from 2.4% in men with zero risk factors to 81.9% in those with a total risk score of 7–8 (p < 0.0005 for linear trend) and in women from 0 to 73.5% (p < 0.0005). The most striking individual impacts on the likelihood for FLI above 60% were observed for physical inactivity (p < 0.0005 for both genders) and alcohol consumption (p < 0.0005 for men). Interestingly, coffee consumption was also found to increase with increasing risk factor scores (p < 0.0005 for linear trend in both genders).ConclusionsThe data indicates that unfavorable combinations of lifestyle risk factors lead to a high likelihood of hepatic steatosis. Use of FLI as a diagnostic tool may benefit the assessment of interventions aimed at maintaining a healthy lifestyle and prevention of liver-related morbidity.
Highlights
Factors of lifestyle may have a major impact on liver-related morbidity and mortality
There was a quadratic trend between age and ordinal lifestyle risk score categories, the highest mean ages being noted in the middle section of the risk categories (p < 0.01) whereas in women a linear trend was observed (p < 0.0005)
The present findings indicate that combinations of unfavorable determinants in lifestyle markedly increase the risk for fatty liver, as assessed using a recently developed predictor algorithm, fatty liver index (FLI)
Summary
Factors of lifestyle may have a major impact on liver-related morbidity and mortality. We examined independent and joint effects of lifestyle risk factors on fatty liver index (FLI), a biomarker of hepatic steatosis, in a population-based cross-sectional national health survey. Excessive alcohol use, smoking, and lack of physical activity are typical risk factors of lifestyle, which may contribute to adiposity, fatty deposition in the liver and increased all-cause mortality [1,2,3,4]. Recent studies have indicated that elevated alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activities are common in obese individuals with mild to moderate alcohol consumption suggesting cumulative hepatotoxic effects for adiposity and alcohol use [6, 9, 10, 12,13,14].
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