Physical Activity Is Associated With Nonalcoholic Fatty Liver Disease and Significant Fibrosis Measured by FibroScan

Kim, Dong‐Hee; Konyn, Peter; Cholankeril, George; Ahmed, Aijaz

doi:10.1016/j.cgh.2021.06.029

Cited by 77 publications

(68 citation statements)

References 29 publications

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“…All participants aged 20 years and over were eligible. Participants were excluded if (1) their dietary intakes of vitamins, carotenoids, or serum vitamin C levels are missing; (2) they are infected with hepatitis B or C (defined by the presence of hepatitis C antibodies or the presence of hepatitis B surface antigen); (3) they have significant alcohol consumption (>30 g/day in men and >20 g/day in women) (13); and (4) their data of transient elastography are missing. The protocol was approved by the National Center for Health Statistics Institutional Review Board, and all subjects provided written informed consent.…”

Section: Eligible Samplementioning

confidence: 99%

“…However, studies on other vitamins and carotenoids and NAFLD are scarce. Transient elastography is considered the non-invasive standard tool for assessing liver fibrosis (11), and provides higher sensitivity and specificity for detecting liver steatosis than liver enzymes (12), and has been adopted to detect liver steatosis and liver fibrosis in the general population (13,14). Therefore, based on the 2017-2018 National Health and Nutrition Examination Survey (NHANES), we aimed to examine the clinical relevance of vitamin A, B vitamins (vitamin B1, vitamin B2, niacin, vitamin B6, folate, vitamin B12, and choline), vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis detected by transient elastography in adults.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Relevance of Vitamins and Carotenoids With Liver Steatosis and Fibrosis Detected by Transient Elastography in Adults

et al. 2021

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Background: Vitamins and carotenoids may be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Previously related publications mainly focused on vitamin D and vitamin E, and studies on other vitamins and carotenoids and NAFLD are scarce.Methods: This study aimed to explore the clinical relevance of vitamin A, B vitamins (vitamin B1, vitamin B2, niacin, vitamin B6, folate, vitamin B12, and choline), vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis in the 2017–2018 NHANES (N = 4,352). Liver steatosis and fibrosis were detected by transient elastography. Logistic regression, linear regression and restricted cubic splines were adopted to explore the non-linear dose-response relationships.Results: Higher intakes of vitamin C [0.68 (0.50–0.93)] and β-carotene [0.71 (0.54–0.93)] were inversely associated with liver steatosis. Higher levels of serum vitamin C [0.45 (0.32–0.62)] were inversely associated with liver fibrosis, while higher intakes of choline [1.43 (1.04–1.98)] and α-carotene [1.67 (1.01–2.74)] were positively associated with liver fibrosis. In addition, marginally inverse association between lutein + zeaxanthin and liver steatosis and positive association between vitamin B12 and liver fibrosis were found. In linear regression, the above-mentioned associations between vitamin C, β-carotene, and lutein + zeaxanthin and liver steatosis, and serum vitamin C, choline, α-carotene, and vitamin B12 and liver fibrosis were also found. The above-mentioned associations were mainly linear, while the relationship between β-carotene and liver steatosis might be non-linear.Conclusion: Vitamin C, α-carotene, β-carotene, lutein + zeaxanthin, choline and vitamin B12 may be associated with liver steatosis and fibrosis.

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Section: Eligible Samplementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Vitamins and Carotenoids With Liver Steatosis and Fibrosis Detected by Transient Elastography in Adults

et al. 2021

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“…Beneficial effects of a healthier lifestyle on fatty liver disease and fibrosis were also reported in previous papers using NHANES 2017-2018 data. [12][13][14] Despite the potential benefit of lifestyle interventions across demographic groups, the COVID-19 pandemic has had a detrimental effect on lifestyle habits of less advantaged groups. A recent systematic review found decreased physical activity levels during the COVID-19 lockdown across almost all reviewed populations and increased sedentary behavior in the majority of studies included.…”

Section: Discussionmentioning

confidence: 99%

“…Increased physical activity is recommended along with a low calorie diet to achieve weight loss among persons with fatty liver disease despite limited information on the relationship of physical activity and diet with fatty liver disease in the general U.S. population. [12][13][14] Recently, the COVID-19 pandemic has augmented health disparities and imposes further challenges in implementation of these lifestyle improvements. A better understanding of social determinants of health, such as access to healthy food or places to exercise, may help to reduce health disparities and achieve health equity which may decrease the fatty liver disease burden among racial and ethnic minority and other underserved populations.…”

Section: Introductionmentioning

confidence: 99%

Prepandemic prevalence estimates of fatty liver disease and fibrosis defined by liver elastography in the United States

Ruhl

2022

Preprint

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Background & AimsFatty liver disease is a growing public health burden with serious consequences. We estimated prepandemic prevalence of fatty liver disease determined by transient elastography assessed hepatic steatosis and fibrosis, and examined associations with lifestyle and other factors in a United States population sample.MethodsLiver stiffness and controlled attenuation parameter (CAP) were assessed on 7,923 non-Hispanic white, non-Hispanic black, non-Hispanic Asian, and Hispanic men and women aged 20 years and over in the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 prepandemic data.ResultsThe prevalence of fatty liver disease estimated by CAP >300 dB/m was 28.8% and of fibrosis (liver stiffness >8 kPa) was 10.4%. Only 7.2% of participants with fatty liver disease and 10.9% with fibrosis reported being told by a health care provider that they had liver disease. In addition to known risk factors such as metabolic factors and ALT, persons with fatty liver disease were less likely to meet physical activity guidelines, more likely to be sedentary for 12 or more hours a day, and reported a less healthy diet. Persons with fibrosis were less likely to have a college degree and reported a less healthy diet.ConclusionIn the U.S. population, most persons with fatty liver disease are unaware of their condition. Although physical activity and dietary modifications might reduce the fatty liver disease burden, the COVID pandemic has been less favorable for lifestyle changes. There is an urgent need for fatty liver disease management in high-risk individuals using transient elastography or other noninvasive methods to intervene in disease progression.

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“…LSM ranges from 1.5 to 75 kPa, with higher values indicating more severe fibrosis ( 24 ). According to the previous studies ( 28 , 29 ), LSM value higher than 8 kPa derived from VCTE was considered as significant liver fibrosis.…”

Section: Methodsmentioning

confidence: 99%

Dietary linoleic acid and the ratio of unsaturated to saturated fatty acids are inversely associated with significant liver fibrosis risk: A nationwide survey

Zhu

Liu

et al. 2022

Front. Nutr.

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Since no pharmaceuticals have been proven to effectively reduce liver fibrosis, dietary fatty acids may be beneficial as one of the non-pharmaceutical interventions due to their important roles in liver metabolism. In this cross-sectional study, we analyzed the data from the 2017–2018 cycle of National Health and Nutrition Examination Survey to examine the associations between the proportion and composition of dietary fatty acid intakes with significant liver fibrosis among US population. The dietary fatty acid consumptions were calculated based on two 24-h dietary recalls. Significant liver fibrosis was diagnosed based on liver stiffness measurement value derived from the vibration controlled transient elastography. Multivariate logistic regression analysis and sensitivity analysis were performed to assess the association between dietary fatty acid consumption and significant liver fibrosis risk. Finally, restricted cubic spline analysis was carried out to explore the dose–response between polyunsaturated fatty acids (PUFA) or linoleic acid intakes and the risk of significant liver fibrosis. The results showed that the multivariate adjusted odds ratios (95% confidence intervals) of significant liver fibrosis were 0.34 (0.14–0.84), 0.68 (0.50–0.91), and 0.64 (0.47–0.87) for the highest level of unsaturated to saturated fatty acid ratio, dietary PUFA, and linoleic acid intakes compared to the lowest reference, respectively. The sensitivity analysis and restricted cubic spline analysis produced similar results, reinforcing the inverse association of unsaturated to saturated fatty acid ratio, PUFA, and linoleic acid consumptions with significant liver fibrosis risk. However, other dietary fatty acids did not show the statistically significant association with significant liver fibrosis. In conclusion, dietary linoleic acid may play a key role in the inverse association between the unsaturated to saturated fatty acid ratio and the risk of significant liver fibrosis. Further studies are needed to confirm these findings.

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Physical Activity Is Associated With Nonalcoholic Fatty Liver Disease and Significant Fibrosis Measured by FibroScan

Cited by 77 publications

References 29 publications

Clinical Relevance of Vitamins and Carotenoids With Liver Steatosis and Fibrosis Detected by Transient Elastography in Adults

Clinical Relevance of Vitamins and Carotenoids With Liver Steatosis and Fibrosis Detected by Transient Elastography in Adults

Prepandemic prevalence estimates of fatty liver disease and fibrosis defined by liver elastography in the United States

Dietary linoleic acid and the ratio of unsaturated to saturated fatty acids are inversely associated with significant liver fibrosis risk: A nationwide survey

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