Genetic predisposition, lifestyle risk, and obesity associate with the progression of nonalcoholic fatty liver disease

Zhenqiu Liu; Chen Suo; Renjia Zhao; Huangbo Yuan; Li Jin; Tiejun Zhang; Xingdong Chen

doi:10.1016/j.dld.2021.07.009

Genetic predisposition, lifestyle risk, and obesity associate with the progression of nonalcoholic fatty liver disease

Dig Liver Dis. 2021 Nov;53(11):1435-1442. doi: 10.1016/j.dld.2021.07.009. Epub 2021 Aug 1.

Authors

Zhenqiu Liu¹, Chen Suo², Renjia Zhao³, Huangbo Yuan¹, Li Jin¹, Tiejun Zhang³, Xingdong Chen⁴

Affiliations

¹ State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, China.
² Fudan University Taizhou Institute of Health Sciences, Taizhou, China; Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China; Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
³ Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China; Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
⁴ State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, China. Electronic address: xingdongchen@fudan.edu.cn.

PMID: 34348882
DOI: 10.1016/j.dld.2021.07.009

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is prevalent worldwide. We aim to identify the factors promoting NAFLD progression.

Methods: 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.

Results: 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.

Conclusion: Adhering to a healthy lifestyle and avoiding obesity are important to prevent NAFLD progression.

Keywords: Genetic risk; Lifestyle risk; NAFLD; Progression.

MeSH terms

Comorbidity
Disease Progression
Female
Genetic Predisposition to Disease*
Health Risk Behaviors*
Humans
Male
Middle Aged
Non-alcoholic Fatty Liver Disease / epidemiology*
Non-alcoholic Fatty Liver Disease / genetics
Obesity / epidemiology*
Proportional Hazards Models
Prospective Studies

Abstract

MeSH terms

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