TY - JOUR
T1 - Depression in non-alcoholic fatty liver disease is associated with an increased risk of complications and mortality
AU - Ng, Cheng Han
AU - Xiao, Jieling
AU - Chew, Nicholas W.S.
AU - Chin, Yip Han
AU - Chan, Kai En
AU - Quek, Jingxuan
AU - Lim, Wen Hui
AU - Tan, Darren Jun Hao
AU - Loke, Ryan Wai Keong
AU - Tan, Caitlyn
AU - Tang, Ansel Shao Pin
AU - Goh, Xin Lei
AU - Nah, Benjamin
AU - Syn, Nicholas
AU - Young, Dan Yock
AU - Tamaki, Nobuharu
AU - Huang, Daniel Q.
AU - Siddiqui, Mohammad Shadab
AU - Noureddin, Mazen
AU - Sanyal, Arun
AU - Muthiah, Mark
N1 - Funding Information:
This work was funded in part by USDA’s National Institute of Food and Agriculture (NIFA) Specialty Crop Research Initiative Projects, “RosBREED: Enabling marker-assisted breeding in Rosaceae” (2009-51181-05858), “RosBREED: Combining disease resistance and horticultural quality in new rosaceous cultivars” (2014-51181-22378), and the NIFA Hatch project 1014919, Crop Improvement and Sustainable Production Systems (WSU reference 00011).
Publisher Copyright:
Copyright © 2022 Ng, Xiao, Chew, Chin, Chan, Quek, Lim, Tan, Loke, Tan, Tang, Goh, Nah, Syn, Young, Tamaki, Huang, Siddiqui, Noureddin, Sanyal and Muthiah.
PY - 2022/10/6
Y1 - 2022/10/6
N2 - Background and aims: The global prevalence of non-alcoholic fatty liver disease (NAFLD) is expected to rise continuously. Furthermore, emerging evidence has also shown the potential for concomitant depression in NAFLD. This study aims to examine the prevalence, risk factors, and adverse events of depression in NAFLD and evaluate whether treated depression can reverse the increased risks of adverse outcomes. Materials and methods: This study analyses the 2000–2018 cycles of NHANES that examined liver steatosis with fatty liver index (FLI). The relationship between NAFLD and depression was assessed with a generalized linear mix model and a sensitivity analysis was conducted in the no depression, treated depression, and untreated depression groups. Survival analysis was conducted with cox regression and fine gray sub-distribution model. Results: A total of 21,414 patients were included and 6,726 were diagnosed with NAFLD. The risk of depression in NAFLD was 12% higher compared to non-NAFLD individuals (RR: 1.12, CI: 1.00–1.26, p = 0.04). NAFLD individuals with depression were more likely to be older, females, Hispanics or Caucasians, diabetic, and have higher BMI. Individuals with depression have high risk for cardiovascular diseases (CVD) (RR: 1.40, CI: 1.25–1.58, p < 0.01), stroke (RR: 1.71, CI: 1.27–2.23, p < 0.01), all-cause mortality (HR: 1.50, CI: 1.25–1.81, p < 0.01), and cancer-related mortality (SHR: 1.43, CI: 1.14–1.80, p = 0.002) compared to NAFLD individuals without depression. The risk of CVD, stroke, all-cause mortality, and cancer-related mortality in NAFLD individuals with treated depression and depression with untreated treatment was higher compared to individuals without depression. Conclusion: This study shows that concomitant depression in NAFLD patients can increase the risk of adverse outcomes. Early screening of depression in high-risk individuals should be encouraged to improve the wellbeing of NAFLD patients.
AB - Background and aims: The global prevalence of non-alcoholic fatty liver disease (NAFLD) is expected to rise continuously. Furthermore, emerging evidence has also shown the potential for concomitant depression in NAFLD. This study aims to examine the prevalence, risk factors, and adverse events of depression in NAFLD and evaluate whether treated depression can reverse the increased risks of adverse outcomes. Materials and methods: This study analyses the 2000–2018 cycles of NHANES that examined liver steatosis with fatty liver index (FLI). The relationship between NAFLD and depression was assessed with a generalized linear mix model and a sensitivity analysis was conducted in the no depression, treated depression, and untreated depression groups. Survival analysis was conducted with cox regression and fine gray sub-distribution model. Results: A total of 21,414 patients were included and 6,726 were diagnosed with NAFLD. The risk of depression in NAFLD was 12% higher compared to non-NAFLD individuals (RR: 1.12, CI: 1.00–1.26, p = 0.04). NAFLD individuals with depression were more likely to be older, females, Hispanics or Caucasians, diabetic, and have higher BMI. Individuals with depression have high risk for cardiovascular diseases (CVD) (RR: 1.40, CI: 1.25–1.58, p < 0.01), stroke (RR: 1.71, CI: 1.27–2.23, p < 0.01), all-cause mortality (HR: 1.50, CI: 1.25–1.81, p < 0.01), and cancer-related mortality (SHR: 1.43, CI: 1.14–1.80, p = 0.002) compared to NAFLD individuals without depression. The risk of CVD, stroke, all-cause mortality, and cancer-related mortality in NAFLD individuals with treated depression and depression with untreated treatment was higher compared to individuals without depression. Conclusion: This study shows that concomitant depression in NAFLD patients can increase the risk of adverse outcomes. Early screening of depression in high-risk individuals should be encouraged to improve the wellbeing of NAFLD patients.
KW - complication
KW - depression
KW - mortality
KW - NAFLD
KW - NASH
KW - NHANES
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U2 - 10.3389/fmed.2022.985803
DO - 10.3389/fmed.2022.985803
M3 - Article
AN - SCOPUS:85140355796
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 985803
ER -