Self-rated health and risk of incident non-alcoholic fatty liver disease: A cohort study

Yoosoo Chang,Yejin Kim,Jin-Won Noh,Seungho Ryu,Joo Young Cheon,Young Dae Kwon

doi:10.1038/s41598-020-60823-8

Abstract

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.

Highlights

Self-rated health (SRH), a subjective measure of overall health status, associates with metabolic abnormalities, studies on the relationship between self-rated health (SRH) and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, are limited
Male sex, high education attainment, high monthly household income, and alcohol consumption were positively associated with better SRH category, whereas part-time job, hypertension, a history of cardiovascular disease (CVD), depressive symptoms based on Center for Epidemiologic Studies Depression (CES-D), insulin resistance estimated by homeostatic model assessment – insulin resistance (HOMA-IR), and systemic inflammation measured by high sensitivity C-reactive protein (hsCRP) were associated with poorer SRH category
The ageand sex-adjusted HRs for incident NAFLD comparing the good, fair, and poor or very poor vs. the very good SRH categories were 1.03 (0.96–1.11), 1.13 (1.05–1.21), and 1.27 (1.17–1.38), respectively (P for trend

Summary

Introduction

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. Male sex, high education attainment, high monthly household income, and alcohol consumption were positively associated with better SRH category, whereas part-time job (vs full-time job), hypertension, a history of CVD, depressive symptoms based on CES-D, insulin resistance estimated by HOMA-IR, and systemic inflammation measured by hsCRP were associated with poorer SRH category.

Results

Conclusion