Nonalcoholic fatty liver disease (NAFLD) is prevalent worldwide. We aim to identify the factors promoting NAFLD progression.
UK Biobank study participants were diagnosed for whether NAFLD presented at baseline. Cox regression model was used to examine the association of risk factors with incident diseases (significant liver diseases [SLDs], type 2 diabetes [T2D], cardiovascular diseases [CVDs], chronic kidney diseases [CKDs], and cancers) among NAFLD cases.
Of 78 283 individuals, 35 159 (44.9%) were females, and the mean (SD) age was 57.56 (7.90) years. Compared with participants had both low genetic and lifestyle risk, individuals with both high genetic and lifestyle risk had a hazard ratio of 1.64 (95% CI 1.32–2.03) for SLDs, 1.16 (1.08–1.24) for T2D, 1.25 (1.13–1.37) for CVDs, 1.33 (1.18–1.49) for CKDs, and 1.13 (1.05-1.22) for cancers. Compared with participants who were non-obese and had low genetic risk, those with obesity and high genetic risk had an 75% (95% CI 38–123%), 147% (128–167%), 46% (33–61%), and 76% (56–99%) increased risk for developing SLDs, T2D, CVDs, and CKDs, respectively. The population-attributable fractions suggested that lifestyle risk and obesity contributed more to the progression of NAFLD than genetic risk.
Adhering to a healthy lifestyle and avoiding obesity are important to prevent NAFLD progression.
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Published online: August 02, 2021
Accepted: July 14, 2021
Received in revised form: July 14, 2021
Received: April 11, 2021
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- Genes and lifestyle: Which of the two is more relevant in driving NAFLD progression?Digestive and Liver DiseaseVol. 53Issue 11
- PreviewA wide spectrum of factors conjointly operate in the pathogenesis of NAFLD and in liver disease progression towards advanced liver disease and comorbidities . At one extreme we find genetic factors: they provide mechanism(s) facilitating liver fat accumulation well before birth, as expressed by epigenetic studies , and are operative throughout life. In recent years several studies have shown that a lot of gene polymorphisms are associated with an increased risk of NAFLD, variably linked with obesity, with the risk of cardiovascular events, with the risk of progression to hepatocellular cancer .