Ying Shang1, Patrik Nasr2, Mattias Ekstedt2, Linnea Widman3, Per Stål4,5, Rolf Hultcrantz4,5, Stergios Kechagias2, Hannes Hagström4,5,6. 1. Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden. 2. Department of Gastroenterology and Hepatology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. 3. Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden. 5. Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden. 6. Clinical Epidemiology Unit, Department of Medicine, Stockholm, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is common in the general population, but its association with dementia is unclear. We aimed to assess the risk of dementia related to NAFLD, and to determine whether histological parameters could improve the predictive capacity of a conventional risk model for dementia in patients with biopsy-proven NAFLD. METHODS: A retrospective matched cohort study of 656 NAFLD patients underwent liver biopsy at 2 hospitals between 1971 and 2009. Up to 10 individuals (controls) from the general population (n = 6,436) were matched for age, sex, and municipality to each patient. Dementia was ascertained from National registers until 2014. Using Cox regression, we estimated hazard ratios for dementia with 95% confidence intervals. In the biopsy cohort, the discriminative power of adding histological markers to a conventional risk model was assessed by Harrell's C-index and compared with a likelihood-ratio test. RESULTS: During a mean follow-up of 19.7 ± 8.7 years, 3.3% of the NAFLD patients and 4.9% of the controls developed dementia (p = 0.07). Overall, NAFLD was not significantly associated with incident dementia. In the biopsy cohort, the model of conventional risk factors (age, sex, hypertension, and cardiovascular diseases) had a C-index of 0.912 to predict incident dementia. Adding individual histological parameters significantly increased the prediction of dementia, with the most pronounced improvement for fibrosis stage (C-index = 0.938, p <0.05). CONCLUSIONS: Although NAFLD was not associated with the risk of dementia, we found that adding histological markers to a conventional risk model for dementia enhanced the predictive capacity, indicating a shared metabolic origin. LAY SUMMARY: Both non-alcoholic fatty liver disease (NAFLD) and dementia are increasing in prevalence because of a more sedentary lifestyle, increased prevalence of obesity and population ageing. However, the link between these 2 diseases is not well studied. We investigated the association between NAFLD and the risk of dementia and found no association. However, liver histology parameters, especially fibrosis, could significantly improve the prediction of dementia risk.
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is common in the general population, but its association with dementia is unclear. We aimed to assess the risk of dementia related to NAFLD, and to determine whether histological parameters could improve the predictive capacity of a conventional risk model for dementia in patients with biopsy-proven NAFLD. METHODS: A retrospective matched cohort study of 656 NAFLD patients underwent liver biopsy at 2 hospitals between 1971 and 2009. Up to 10 individuals (controls) from the general population (n = 6,436) were matched for age, sex, and municipality to each patient. Dementia was ascertained from National registers until 2014. Using Cox regression, we estimated hazard ratios for dementia with 95% confidence intervals. In the biopsy cohort, the discriminative power of adding histological markers to a conventional risk model was assessed by Harrell's C-index and compared with a likelihood-ratio test. RESULTS: During a mean follow-up of 19.7 ± 8.7 years, 3.3% of the NAFLD patients and 4.9% of the controls developed dementia (p = 0.07). Overall, NAFLD was not significantly associated with incident dementia. In the biopsy cohort, the model of conventional risk factors (age, sex, hypertension, and cardiovascular diseases) had a C-index of 0.912 to predict incident dementia. Adding individual histological parameters significantly increased the prediction of dementia, with the most pronounced improvement for fibrosis stage (C-index = 0.938, p <0.05). CONCLUSIONS: Although NAFLD was not associated with the risk of dementia, we found that adding histological markers to a conventional risk model for dementia enhanced the predictive capacity, indicating a shared metabolic origin. LAY SUMMARY: Both non-alcoholic fatty liver disease (NAFLD) and dementia are increasing in prevalence because of a more sedentary lifestyle, increased prevalence of obesity and population ageing. However, the link between these 2 diseases is not well studied. We investigated the association between NAFLD and the risk of dementia and found no association. However, liver histology parameters, especially fibrosis, could significantly improve the prediction of dementia risk.
Authors: Eugene Y H Tang; Stephanie L Harrison; Linda Errington; Mark F Gordon; Pieter Jelle Visser; Gerald Novak; Carole Dufouil; Carol Brayne; Louise Robinson; Lenore J Launer; Blossom C M Stephan Journal: PLoS One Date: 2015-09-03 Impact factor: 3.240
Authors: Seogsong Jeong; Yun Hwan Oh; Seulggie Choi; Jooyoung Chang; Sung Min Kim; Joung Sik Son; Gyeongsil Lee; Joseph C Ahn; Dong Hyeon Lee; Bo Kyung Koo; Won Kim; Sang Min Park Journal: Clin Mol Hepatol Date: 2022-03-17