Influence Factors On Prevalence And Incidence Of Fatty Liver In Jinchang Cohort

Objectives To confirm high risk populations for fatty liver by calculating the prevalence and incidence of fatty liver in the Jinchang Cohort,and to explore factors influencing the prevalence and incidence of alcoholic fatty liver disease(AFLD)and non-alcoholic fatty liver disease(NAFLD),in order to provide evidence-base suggestions for the health interventions in the cohort and to provide guidance for prevention and control work of fatty liver.Methods The Jinchang Cohort was established through the collection of data from epidemiological surveys,health examinations,and laboratory analysis of Jinchuan Company employees between June 2011 and December 2013.The first phase of follow-up was conducted from January 2014 to November 2015.This study dependented on both the baseline and follow-up survey.Prevalence and cumulative incidence for two years of fatty liver were calculated.High risk populations were identified by describing the prevalence stratified by different indicators.Logistic regression analysis was used to find the prevalence influence factors for NAFLD and AFLD and to estimate the odds ratio and 95% confidence interval of each factor.Cox proportional hazards model was used to find incidence influence factors for NAFLD and AFLD and to estimate the hazard ratio and 95% confidence interval.Results 1.The prevalence of fatty liver in the Jinchang Cohort was 22.24% overall,27.29% in males,and 13.48% in females.The prevalence of NAFLD was 16.76% overall,19.08% in males,and 13.10% in females.The prevalence of AFLD was 3.33% overall,5.40% in males,and 0.05% in females.Prevalence of fatty liver initially rose and then decreased with increasing age.The prevalence of fatty liver is higher among males and females with high household per capita income,high oil diets,lack of exercise,gallstones or more than two kinds of gallbladder diseases,and overweight or obesity;males with managerial positions or high education,or who drink tea or alcohol;and females with services positions or low education.Cumulative incidence for two years of fatty liver was 7.90% overall,8.07% in males,and 7.64% in females.Cumulative incidence for two years of NAFLD was 6.69% overall,6.23% in males,and 7.42% in females.Cumulative incidence for two years of AFLD was 0.47% overall,0.75% in males,and 0.02% in females.Incidence of fatty toke on a bi-modal distribution and initially rose and then decreased with increasing age.The incidence of fatty liver in males was higher than females before 55 years of age and lower after.2.Logistic regression analysis showed that the risk factors of NAFLD in males were old age,high education,high household per capita income,gallstones,overweight or obesity,high fasting blood glucose,high uric acid,high blood pressure,abnormal lipid,high alanine transaminase,high gamma glutamyl transpeptidase,and high cholinesterase.Protect factors were regular exercise,chronic cholecystitis,and moderate drinking.The risk factors of NAFLD in females were old age,high education,household per capita income ? 5000 RMB,high oil diets,gallstones,overweight or obesity,high fasting blood glucose,high uric acid,high blood pressure,abnormal lipid,high alanine transaminase,high gamma glutamyl transpeptidase,high cholinesterase,and high total bile acid.Protective factors were moderate drinking,gallbladder polyps,and occasionally or regular exercise.The risk factors of AFLD among males were old age,high oil diets,drinking,overweight or obesity,high fasting blood glucose,high uric acid,high blood pressure,abnormal lipid,high prealbumin,high alanine transaminase,and high gamma-glutamyl transpeptidase.The protective factor was regular exercise.3.Cox regression analysis showed that the risk factors of NAFLD in males were high education,high household per capita income,overweight or obesity,high fasting blood glucose,high uric acid,abnormal lipid,high alanine transaminase,and high cholinesterase.Protective factors were occasionally or regular exercise and moderate drinking.The risk factors of NAFLD among females were high oil diets,gallstones,overweight or obesity,high fasting blood glucose,high uric acid,abnormal lipid,and high gamma glutamyl transpeptidase.Protective factors were regular exercise and moderate drinking.The risk factors of AFLD in males were drinking,overweight or obesity,abnormal lipid,and high gamma glutamyl transpeptidase.Protective factor was regular exercise.4.Among the 8 HBV models,HBsAg,HBeAg,and HBcAb positive;HBsAg and HBcAb positive;and HBsAg,HBeAb,and HBcAb positive were least prevalence in the Jinchang Cohort.Logistic regression analysis showed that HBsAg and HBcAb positive,and HBsAg,HBeAg,and HBcAb positive could decrease the prevalence risk of fatty liver.Among the 4 HBV markers,prevalence of fatty liver was lower in the HBsAg or HbeAg positive groups than in the HBsAg or HbeAg negative groups.Conclusions 1.Both the prevalence and incidence of fatty liver were much higher in the Jinchang Cohort,with the burden primarily due to NAFLD.High risk populations for fatty liver were males and females with high household per capita income,overweight or obesity,gallstones,high oil diets and lack of exercise;males with managerial positions,high education,drinking tea or alcohol;and females with services positions,low education.2.The main influence factors for NAFLD and AFLD were different.Drinking was the main risk factor for AFLD,while components of metabolic syndrome were the main risk factors for NAFLD.3.Prospectie cohort study conformed that the risk factors of NAFLD were overweight or obesity,high fasting blood glucose,high uric acid,abnormal lipid,high oil diets,high household per capita income,gallstones,high alanine transaminase,and high cholinesterase.Protective factors were regular exercise and moderate drinking.4.Prospectie cohort study conformed that the risk factors of AFLD were drinking,overweight or obesity,abnormal lipid,and high cholinesterase,while protective factor were regular exercise.5.Acute HBV infection may reduce the prevalence risk of fatty liver,however,there was no relationship between the total HBV infections and fatty liver.