Non-alcoholic fatty liver disease associated with greater herpes zoster risk than alcoholic fatty liver disease

Cheng-Wei Yu; Chia-Hung Chen; Yung-Chi Cheng; Wen-Che Hsieh; Tzu-Ju Hsu; Fuu-Jen Tsai; Chao-Yu Hsu

doi:10.1186/s40001-023-01524-6

Non-alcoholic fatty liver disease associated with greater herpes zoster risk than alcoholic fatty liver disease

Eur J Med Res. 2023 Dec 2;28(1):550. doi: 10.1186/s40001-023-01524-6.

Authors

Cheng-Wei Yu¹, Chia-Hung Chen^{2

3}, Yung-Chi Cheng^{2

4}, Wen-Che Hsieh⁵, Tzu-Ju Hsu⁶, Fuu-Jen Tsai^{7

8

9

10}, Chao-Yu Hsu^{11

12

13

14

15}

Affiliations

¹ Department of Nutrition, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan.
² Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan.
³ Department of Medical Imaging, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan.
⁴ Department of Rehabilitation, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan.
⁵ Department of Chinese Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan.
⁶ Management Office for Health Data, Clinical Trial Research Center, China Medical University Hospital, Taichung, 404, Taiwan.
⁷ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 404, Taiwan.
⁸ Department of Medical Research, China Medical University Hospital, Taichung, 404, Taiwan.
⁹ Division of Medical Genetics, China Medical University Children's Hospital, Taichung, 404, Taiwan.
¹⁰ Department of Biotechnology and Bioinformatics, Asia University, Taichung, 413, Taiwan.
¹¹ Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan. 07692@cych.org.tw.
¹² Department of Artificial Intelligence and Healthcare Management, Central Taiwan University of Science and Technology 406, Taichung, Taiwan. 07692@cych.org.tw.
¹³ Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, 406, Taiwan. 07692@cych.org.tw.
¹⁴ Center for General Education, National Taichung University of Science and Technology, Taichung, 404, Taiwan. 07692@cych.org.tw.
¹⁵ Department of General Education, National Chin-Yi University of Technology, Taichung, 411, Taiwan. 07692@cych.org.tw.

Abstract

Background: Disease-related stress can trigger the occurrence of herpes zoster (HZ). Fatty liver disease (FLD) can have adverse effects on the human body and may induce stress in affected individuals. In this study, we investigated whether FLD is associated with an elevated risk of HZ.

Methods: For this study, we utilized data from the National Health Insurance Research Database, patients with FLD from 2000 to 2017 were observed (follow-up until 2018). Patients were considered to have FLD if they had at least two outpatient visits or at least one admission record with a diagnostic code of FLD. Patients with FLD were matched 1:1 by age, sex, comorbidities, and index year with control patients. Additionally, the FLD was further categorized into non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD) groups. Multivariable Cox proportional hazards model was used to calculate the incidence rate and adjusted hazard ratio (aHR) of HZ for FLD and AFLD and for various age groups, sex and comorbidities. Cumulative incidence curve for HZ was plotted through the Kaplan-Meier method, and p-value was calculated using the log-rank test.

Results: After 1:1 propensity-score matching, each cohort comprised 62,418 patients. The FLD cohort was further divided into NAFLD and AFLD groups, which respectively comprised 55,709 and 6709 patients. The FLD cohort had a risk of HZ significantly higher than that of the control cohort (aHR = 1.06; p < 0.001). Additionally, the NAFLD group exhibited a significantly higher risk of HZ than did the AFLD group (aHR = 1.22; p < 0.001). Among patients without any comorbidities, those with FLD had a higher risk of HZ than did those without FLD (aHR = 1.14; p < 0.001).

Conclusion: Patients with FLD are at an increased risk of HZ development. Additionally, NAFLD is associated with a higher risk of HZ than AFLD. Therefore, patients with NAFLD should be informed of their increased risk of HZ.

Keywords: Alcoholic fatty liver disease; Herpes zoster; Non-alcoholic fatty liver disease.

MeSH terms

Age Factors
Comorbidity
Fatty Liver, Alcoholic* / complications
Fatty Liver, Alcoholic* / epidemiology
Herpes Zoster* / complications
Herpes Zoster* / epidemiology
Humans
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / epidemiology
Risk Factors