Skip to main content
Top
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Fatty Liver | Research

Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study

Authors: Negin Kamari, Hawal Lateef Fateh, Mitra Darbandi, Farid Najafi, Mozhgan Moradi, Yahya Pasdar

Published in: BMC Gastroenterology | Issue 1/2023

Login to get access

Abstract

Background

Lifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver index (FLI) in Iranian adults.

Methods

This study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle.

Results

Participants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42–2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06–2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05).

Conclusion

In our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.
Literature
1.
go back to reference Toma C, Day CP, Trenell M. I. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. J Hepatol. 2012;56:255–66.CrossRef Toma C, Day CP, Trenell M. I. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. J Hepatol. 2012;56:255–66.CrossRef
2.
go back to reference Zarean E, Goujani R, Rahimian G, Ahamdi A. Prevalence and risk factors of non-alcoholic fatty liver disease in southwest Iran: a population-based case-control study. Clin Exp Hepatol. 2019;5:224.CrossRefPubMedPubMedCentral Zarean E, Goujani R, Rahimian G, Ahamdi A. Prevalence and risk factors of non-alcoholic fatty liver disease in southwest Iran: a population-based case-control study. Clin Exp Hepatol. 2019;5:224.CrossRefPubMedPubMedCentral
4.
go back to reference Flisiak-Jackiewicz M, Bobrus-Chociej A, Wasilewska N, Lebensztejn DM. From Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—New Terminology in Pediatric Patients as a Step in Good Scientific Direction. Journal of Clinical Medicine. 2021 Mar 1;10(5):924. Flisiak-Jackiewicz M, Bobrus-Chociej A, Wasilewska N, Lebensztejn DM. From Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—New Terminology in Pediatric Patients as a Step in Good Scientific Direction. Journal of Clinical Medicine. 2021 Mar 1;10(5):924.
5.
go back to reference Jia G, Li X, Wang L, Li Q, Yang L, Li N, Di F. Relationship of socioeconomic status and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Zhonghua Gan Zang Bing Za Zhi Zhonghua Ganzangbing Zazhi Chin J Hepatol. 2015;23:760–4. Jia G, Li X, Wang L, Li Q, Yang L, Li N, Di F. Relationship of socioeconomic status and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Zhonghua Gan Zang Bing Za Zhi Zhonghua Ganzangbing Zazhi Chin J Hepatol. 2015;23:760–4.
6.
go back to reference Orkin S, Brokamp C, Yodoshi T, Trout AT, Liu C, Meryum S, Taylor S, Wolfe C, Sheridan R, Seth A. Community socioeconomic deprivation and nonalcoholic fatty liver Disease Severity. J Pediatr Gastroenterol Nutr. 2020;70:364–70.CrossRefPubMedPubMedCentral Orkin S, Brokamp C, Yodoshi T, Trout AT, Liu C, Meryum S, Taylor S, Wolfe C, Sheridan R, Seth A. Community socioeconomic deprivation and nonalcoholic fatty liver Disease Severity. J Pediatr Gastroenterol Nutr. 2020;70:364–70.CrossRefPubMedPubMedCentral
7.
go back to reference Lim EX, Forde CG, Cheon BK. Low subjective socioeconomic status alters taste-based perceptual sensitivity to the energy density of beverages. Physiol Behav. 2020;223:112989.CrossRefPubMed Lim EX, Forde CG, Cheon BK. Low subjective socioeconomic status alters taste-based perceptual sensitivity to the energy density of beverages. Physiol Behav. 2020;223:112989.CrossRefPubMed
8.
go back to reference European Association for the Study of the Liver (EASL). European Association for the study of diabetes (EASD); european asso- ciation for the study of obesity (EASO). EASL–EASD–EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402.CrossRef European Association for the Study of the Liver (EASL). European Association for the study of diabetes (EASD); european asso- ciation for the study of obesity (EASO). EASL–EASD–EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388–402.CrossRef
9.
go back to reference Reginato E, Pippi R, Aiello C, Sbroma Tomaro E, Ranucci C, Buratta L, Bini V, Marchesini G, De Feo P, Fanelli C. Effect of short term intensive lifestyle intervention on hepatic steatosis indexes in adults with obesity and/or type 2 diabetes. J Clin Med. 2019;8:851.CrossRefPubMedPubMedCentral Reginato E, Pippi R, Aiello C, Sbroma Tomaro E, Ranucci C, Buratta L, Bini V, Marchesini G, De Feo P, Fanelli C. Effect of short term intensive lifestyle intervention on hepatic steatosis indexes in adults with obesity and/or type 2 diabetes. J Clin Med. 2019;8:851.CrossRefPubMedPubMedCentral
10.
go back to reference Serfaty L. Management of patients with non-alcoholic steatohepatitis (NASH) in real life. Liver Int. 2018;38:52–5.CrossRefPubMed Serfaty L. Management of patients with non-alcoholic steatohepatitis (NASH) in real life. Liver Int. 2018;38:52–5.CrossRefPubMed
11.
go back to reference Centis E, Moscatiello S, Bugianesi E, Bellentani S, Fracanzani AL, Calugi S, Petta S, Dalle-Grave R, Marchesini G. Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease. J Hepatol. 2013;58:771–7.CrossRefPubMed Centis E, Moscatiello S, Bugianesi E, Bellentani S, Fracanzani AL, Calugi S, Petta S, Dalle-Grave R, Marchesini G. Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease. J Hepatol. 2013;58:771–7.CrossRefPubMed
12.
go back to reference Assimakopoulos K, Karaivazoglou K, Tsermpini E-E, Diamantopoulou G, Triantos C. Quality of life in patients with nonalcoholic fatty liver disease: a systematic review. J Psychosom Res. 2018;112:73–80.CrossRefPubMed Assimakopoulos K, Karaivazoglou K, Tsermpini E-E, Diamantopoulou G, Triantos C. Quality of life in patients with nonalcoholic fatty liver disease: a systematic review. J Psychosom Res. 2018;112:73–80.CrossRefPubMed
15.
go back to reference Pasdar Y, Naja F, Moradinazar M, Shakiba E, Karim H, Hamzeh B, et al. Cohort pro le: Ravansar Non-Communicable Disease cohort study: the first cohort study in a kurdish population. Inter J Epidemiol. 2019;48(3):682–3.CrossRef Pasdar Y, Naja F, Moradinazar M, Shakiba E, Karim H, Hamzeh B, et al. Cohort pro le: Ravansar Non-Communicable Disease cohort study: the first cohort study in a kurdish population. Inter J Epidemiol. 2019;48(3):682–3.CrossRef
16.
go back to reference Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, et al. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591–602.CrossRefPubMedPubMedCentral Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, et al. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591–602.CrossRefPubMedPubMedCentral
17.
18.
go back to reference Huang X, et al. Validation of the fatty liver index for nonalcoholic fatty liver disease in middle-aged and elderly chinese. Medicine. 2015;94:1682.CrossRef Huang X, et al. Validation of the fatty liver index for nonalcoholic fatty liver disease in middle-aged and elderly chinese. Medicine. 2015;94:1682.CrossRef
20.
go back to reference Byrne CD, Targher GNAFLD. A multisystem disease. J Hepatol. 2015;62:47–S64.CrossRef Byrne CD, Targher GNAFLD. A multisystem disease. J Hepatol. 2015;62:47–S64.CrossRef
21.
go back to reference Rocha R, Cotrim HP, Carvalho FM, et al. Body mass index and waist circumference in non-alcoholic fatty liver disease. J Hum Nutr Diet. 2005;18(5):365–70.CrossRefPubMed Rocha R, Cotrim HP, Carvalho FM, et al. Body mass index and waist circumference in non-alcoholic fatty liver disease. J Hum Nutr Diet. 2005;18(5):365–70.CrossRefPubMed
22.
go back to reference Anderson EL, Howe LD, Jones HE et al. The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta- analysis. PLoS ONE 2015;10(10). Anderson EL, Howe LD, Jones HE et al. The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta- analysis. PLoS ONE 2015;10(10).
23.
go back to reference Marchesini G, Petta S, Dalle Grave R. Diet, weight loss, and liver health in nonalcoholic fatty liver disease: pathophysiology, evidence, and practice. Hepatology. 2016;63(6):2032–43.CrossRefPubMed Marchesini G, Petta S, Dalle Grave R. Diet, weight loss, and liver health in nonalcoholic fatty liver disease: pathophysiology, evidence, and practice. Hepatology. 2016;63(6):2032–43.CrossRefPubMed
24.
go back to reference Sathiaraj E, Chutke M, Reddy MY, et al. A case-control study on nutritional risk factors in non-alcoholic fatty liver disease in indian population. Eur J Clin Nutr. 2011;65(4):533–7.CrossRefPubMed Sathiaraj E, Chutke M, Reddy MY, et al. A case-control study on nutritional risk factors in non-alcoholic fatty liver disease in indian population. Eur J Clin Nutr. 2011;65(4):533–7.CrossRefPubMed
25.
go back to reference Alberti KG, Zimmet P, Shaw J. Metabolic syndrome-a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469–80.CrossRefPubMed Alberti KG, Zimmet P, Shaw J. Metabolic syndrome-a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23:469–80.CrossRefPubMed
26.
go back to reference Zhan Y, Yu J, Chen R, Gao J, Ding R, Fu Y, Zhang L, Hu D. Socioeconomic status and metabolic syndrome in the general population of China: a cross-sectional study. BMC Public Health. 2012;12:921.CrossRefPubMedPubMedCentral Zhan Y, Yu J, Chen R, Gao J, Ding R, Fu Y, Zhang L, Hu D. Socioeconomic status and metabolic syndrome in the general population of China: a cross-sectional study. BMC Public Health. 2012;12:921.CrossRefPubMedPubMedCentral
27.
go back to reference Goodman E, Daniels SR, Dolan LM. Socioeconomic disparities in insulin resistance: results from the Princeton School District Study. Psychosom Med. 2007;69:61–7.CrossRefPubMed Goodman E, Daniels SR, Dolan LM. Socioeconomic disparities in insulin resistance: results from the Princeton School District Study. Psychosom Med. 2007;69:61–7.CrossRefPubMed
28.
go back to reference Tomah S, Hamdy O, Abuelmagd MM, Hassan AH, Alkhouri N, Al-Badri MR, Gardner H, Eldib AH, Eid EA. Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt. BMJ open gastroenterology. 2021 Oct 1;8(1):e000780. Tomah S, Hamdy O, Abuelmagd MM, Hassan AH, Alkhouri N, Al-Badri MR, Gardner H, Eldib AH, Eid EA. Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt. BMJ open gastroenterology. 2021 Oct 1;8(1):e000780.
29.
go back to reference Joo JH, Kim HJ, Park EC, Jang SI. Association between sitting time and non-alcoholic fatty liver disease in South Korean population: a cross-sectional study. Lipids Health Dis. 2020 Sep 23;19(1):212. doi: https://doi.org/10.1186/s12944-020-01385-6. PMID: 32967678; PMCID: PMC7513533. Joo JH, Kim HJ, Park EC, Jang SI. Association between sitting time and non-alcoholic fatty liver disease in South Korean population: a cross-sectional study. Lipids Health Dis. 2020 Sep 23;19(1):212. doi: https://​doi.​org/​10.​1186/​s12944-020-01385-6. PMID: 32967678; PMCID: PMC7513533.
30.
go back to reference Hallsworth K, Fattakhova G, Hollingsworth KG, et al. Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011;60:1278–83.CrossRefPubMed Hallsworth K, Fattakhova G, Hollingsworth KG, et al. Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011;60:1278–83.CrossRefPubMed
31.
go back to reference Berzigotti A, Saran U, Dufour JF. Physical activity and liver diseases. Hepatology. 2016;63(3):1026–40.CrossRefPubMed Berzigotti A, Saran U, Dufour JF. Physical activity and liver diseases. Hepatology. 2016;63(3):1026–40.CrossRefPubMed
32.
go back to reference Soleimani D, Ranjbar G, Rezvani R, Goshayeshi L, Razmpour F, Nematy M. Dietary patterns in relation to hepatic brosis among patients with nonalcoholic fatty liver disease. Diabetes Metab Syndr Obes. 2019;12:315–24.CrossRefPubMedPubMedCentral Soleimani D, Ranjbar G, Rezvani R, Goshayeshi L, Razmpour F, Nematy M. Dietary patterns in relation to hepatic brosis among patients with nonalcoholic fatty liver disease. Diabetes Metab Syndr Obes. 2019;12:315–24.CrossRefPubMedPubMedCentral
33.
go back to reference Kalafati IP, Borsa D, Dimitriou M, Revenas K, Kokkinos A, Dedoussis GV. Dietary patterns and non-alcoholic fatty liver disease in a greek case-control study. Nutrition. 2019;61:105–10.CrossRefPubMed Kalafati IP, Borsa D, Dimitriou M, Revenas K, Kokkinos A, Dedoussis GV. Dietary patterns and non-alcoholic fatty liver disease in a greek case-control study. Nutrition. 2019;61:105–10.CrossRefPubMed
34.
go back to reference Chan R, Wong VW, Chu WC, Wong GL, Li LS, Leung J, Chim AM, Yeung DK, Sea MM, Woo J, et al. Diet-quality scores and prevalence of nonalcoholic fatty liver disease: a population study using proton-magnetic resonance spectroscopy. PLoS ONE. 2015;10:e0139310.CrossRefPubMedPubMedCentral Chan R, Wong VW, Chu WC, Wong GL, Li LS, Leung J, Chim AM, Yeung DK, Sea MM, Woo J, et al. Diet-quality scores and prevalence of nonalcoholic fatty liver disease: a population study using proton-magnetic resonance spectroscopy. PLoS ONE. 2015;10:e0139310.CrossRefPubMedPubMedCentral
35.
go back to reference Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non- alcoholic fatty liver disease (NAFLD). Metabolism. 2016;65:1038–48.CrossRefPubMed Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non- alcoholic fatty liver disease (NAFLD). Metabolism. 2016;65:1038–48.CrossRefPubMed
36.
go back to reference Zelber-Sagi S, Ratziu V, Oren R. Nutrition and physical activity in NAFLD: an overview of the epidemiological evidence. World J Gastroenterol. 2011;17:3377–89.CrossRefPubMedPubMedCentral Zelber-Sagi S, Ratziu V, Oren R. Nutrition and physical activity in NAFLD: an overview of the epidemiological evidence. World J Gastroenterol. 2011;17:3377–89.CrossRefPubMedPubMedCentral
37.
go back to reference Ma J, Hennein R, Liu C, Long MT, Ho mann U, Jacques PF, Lichtenstein AH, Hu FB, Levy D. Improved diet quality associates with reduction in liver fat, particularly in individuals with high genetic risk scores for nonalcoholic fatty liver disease. Gastroenterology. 2018;155:107–17.CrossRefPubMed Ma J, Hennein R, Liu C, Long MT, Ho mann U, Jacques PF, Lichtenstein AH, Hu FB, Levy D. Improved diet quality associates with reduction in liver fat, particularly in individuals with high genetic risk scores for nonalcoholic fatty liver disease. Gastroenterology. 2018;155:107–17.CrossRefPubMed
38.
go back to reference Elwing JE, Lustman PJ, Wang HL, Clouse RE. Depression, anxiety, and nonalcoholic steatohepatitis. Psychosom Med. 2006;68(4):563–9.CrossRefPubMed Elwing JE, Lustman PJ, Wang HL, Clouse RE. Depression, anxiety, and nonalcoholic steatohepatitis. Psychosom Med. 2006;68(4):563–9.CrossRefPubMed
39.
go back to reference Surdea-Blaga T, Dumitrascu DL. Depression and anxiety in nonalcoholic steatohepatitis: is there any association? Rom J Intern Med. 2011;49(4):273–80.PubMed Surdea-Blaga T, Dumitrascu DL. Depression and anxiety in nonalcoholic steatohepatitis: is there any association? Rom J Intern Med. 2011;49(4):273–80.PubMed
40.
go back to reference Maes M, Mihaylova I, Kubera M, Leunis JC, Ge ard M. IgM-mediated auto- immune responses directed against multiple neoepitopes in depression: new pathways that underpin the inflammatory and neuroprogressive pathophysiology. J A ect Disord. 2011;135(1–3):414–8.CrossRef Maes M, Mihaylova I, Kubera M, Leunis JC, Ge ard M. IgM-mediated auto- immune responses directed against multiple neoepitopes in depression: new pathways that underpin the inflammatory and neuroprogressive pathophysiology. J A ect Disord. 2011;135(1–3):414–8.CrossRef
41.
go back to reference Lu W, Li S, Li J, Wang J, Zhang R, Zhou Y, Yin Q, Zheng Y, Wang F, Xia Y, Chen K. Effects of omega-3 fatty acid in nonalcoholic fatty liver disease: a meta-analysis. Gastroenterol Res Pract 2016 Oct 28;2016. Lu W, Li S, Li J, Wang J, Zhang R, Zhou Y, Yin Q, Zheng Y, Wang F, Xia Y, Chen K. Effects of omega-3 fatty acid in nonalcoholic fatty liver disease: a meta-analysis. Gastroenterol Res Pract 2016 Oct 28;2016.
Metadata
Title
Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study
Authors
Negin Kamari
Hawal Lateef Fateh
Mitra Darbandi
Farid Najafi
Mozhgan Moradi
Yahya Pasdar
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Fatty Liver
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02785-5

Other articles of this Issue 1/2023

BMC Gastroenterology 1/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.