Skip to main content

ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1502671

Analysis of the Association Between Non-Alcoholic Fatty Liver Disease (NAFLD) and Mortality in US Adults

Provisionally accepted
Fen Rong Fen Rong 1*Yiyi Mai Yiyi Mai 1Lujia Shou Lujia Shou 2Xinya Zhu Xinya Zhu 1*Meiyue Li Meiyue Li 1Liuchen Zhu Liuchen Zhu 1*Xiuli Sun Xiuli Sun 3*Xinhua Zhao Xinhua Zhao 2*
  • 1 School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 2 School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 3 Library, Shanghai University of Traditional Chinese Medicine, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: Non-alcoholic Fatty Liver Disease (NAFLD) is a prevalent condition characterized by the accumulation of fat in the liver, often linked with increased risk for multi-systemic diseases. This study aims to investigate the relationship between NAFLD and mortality, particularly all-cause and cardiovascular mortality, among US adults. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) were utilized, encompassing 80,312 participants from 2003-2004 to 2017-2018. After exclusions for incomplete data, potential other liver diseases, and significant alcohol consumption, the final analytical cohort included 32,698 participants. The Fatty Liver Index (FLI), a non-invasive diagnostic tool, was used to identify NAFLD. Covariates included demographic characteristics, lifestyle factors, and biochemical parameters. Survival analysis was conducted using a weighted Cox proportional hazards regression model to quantify the impact of NAFLD on mortality. Results: The study revealed that NAFLD was significantly associated with increased risks of all-cause and cardiovascular disease (CVD) mortality. The hazard ratios (HRs) from the survival analysis consistently indicated a higher risk among participants with NAFLD compared to those without. Subgroup analyses further confirmed the association, with notable exceptions in certain subgroups such as those with high school education and diabetes. Additionally, a nonlinear relationship between serum uric acid (SUA) levels and mortality risk was identified among NAFLD participants. Conclusion: NAFLD is a significant risk factor for all-cause and CVD mortality in US adults. The findings underscore the importance of early detection and intervention for NAFLD to mitigate its impact on public health. Further research is needed to explore the complex interactions between NAFLD, SUA levels, and mortality, particularly in high-risk subgroups.

    Keywords: Non-alcoholic fatty liver disease, All-cause mortality, CVD mortality, Fatty liver index, Serum uric acid

    Received: 27 Sep 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Rong, Mai, Shou, Zhu, Li, Zhu, Sun and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Fen Rong, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
    Xinya Zhu, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
    Liuchen Zhu, School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
    Xiuli Sun, Library, Shanghai University of Traditional Chinese Medicine, Shanghai, China
    Xinhua Zhao, School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.