Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity.
Only some individuals with obesity develop liver fibrosis due to non-alcoholic fatty liver disease (NAFLD-fibrosis). We determined whether detailed assessment of lifestyle factors in addition to physical, biochemical and genetic factors helps in identification of these patients. A total of 100 patients with obesity (mean BMI 40.0 ± 0.6 kg/m2) referred for bariatric surgery at the Helsinki University Hospital underwent a liver biopsy to evaluate liver histology. Physical activity was determined by accelerometer recordings and by the Modifiable Activity Questionnaire, diet by the FINRISK Food Frequency Questionnaire, and other lifestyle factors, such as sleep patterns and smoking, by face-to-face interviews. Physical and biochemical parameters and genetic risk score (GRS based on variants in PNPLA3, TM6SF2, MBOAT7 and HSD17B13) were measured. Of all participants 49% had NAFLD-fibrosis. Independent predictors of NAFLD-fibrosis were low moderate-to-vigorous physical activity, high red meat intake, low carbohydrate intake, smoking, HbA1c, triglycerides and GRS. A model including these factors (areas under the receiver operating characteristics curve (AUROC) 0.90 (95% CI 0.84-0.96)) identified NAFLD-fibrosis significantly more accurately than a model including all but lifestyle factors (AUROC 0.82 (95% CI 0.73-0.91)) or models including lifestyle, physical and biochemical, or genetic factors alone. Assessment of lifestyle parameters in addition to physical, biochemical and genetic factors helps to identify obese patients with NAFLD-fibrosis.
['Lahelma|Mari|M|', 'Luukkonen|Panu K|PK|', 'Qadri|Sami|S|0000-0001-9313-9324', 'Ahlholm|Noora|N|', 'Lallukka-Brück|Susanna|S|0000-0002-9775-6669', 'Porthan|Kimmo|K|', 'Juuti|Anne|A|', 'Sammalkorpi|Henna|H|', 'Penttilä|Anne K|AK|', 'Arola|Johanna|J|', 'Orho-Melander|Marju|M|', 'Yki-Järvinen|Hannele|H|']
D000328:Adult D050110:Bariatric Surgery D004032:Diet D015444:Exercise D005260:Female D020022:Genetic Predisposition to Disease D006801:Humans D008019:Life Style D008099:Liver D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D065626:Non-alcoholic Fatty Liver Disease D009765:Obesity D011446:Prospective Studies D012890:Sleep D012959:Socioeconomic Factors D013315:Stress, Psychological
physical activity diet glucose insulin stress