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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- 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
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
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