Association between non-alcoholic fatty liver disease and autonomic dysfunction in a Chinese population

QJM. 2015 Aug;108(8):617-24. doi: 10.1093/qjmed/hcv006. Epub 2015 Jan 21.


Background: Autonomic dysfunction (AD) accompanying with chronic liver disorders led to an increased risk of mortality. However, researches that investigated the association between non-alcoholic fatty liver disease (NAFLD) and AD were insufficient.

Aims: To study the association of NAFLD with AD in middle-aged and elderly Chinese adults.

Design: Four thousand nine hundred seventy-four adults aged 40 years or older were enrolled in this cross-sectional study. NAFLD was diagnosed by hepatic B-mode ultrasonography. Autonomic function was assessed using a simple EZSCAN test by measuring sudomotor function, with an AD index > 50% defined as a manifestation of AD.

Methods: Pearson correlation, multiple stepwise linear regression, univariate and multivariate logistic regression was employed to examine the relationship between NAFLD and AD, controlling for potential confounders.

Results: The prevalence of AD was significantly higher in participants with NAFLD than those without (40.75 vs. 26.86%, P < 0.0001). Age, body mass index, status of diabetes, sex, diastolic blood pressure and prevalent NAFLD, were positively correlated with AD index in multiple stepwise linear regression analysis (all P < 0.05), whereas total cholesterol was negatively related to it (P = 0.0043). Compared with the participants without NAFLD, those with NAFLD had an increased odds of the prevalent AD (odds ratio 1.38; 95% confidence interval 1.15-1.64; P = 0.0004) after controlling for multiple confounders.

Conclusions: The presence of NAFLD was significantly associated with AD, as indicated by abnormal sudomotor function. The association was independent from various conventional risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Autonomic Nervous System Diseases / diagnosis
  • Autonomic Nervous System Diseases / epidemiology
  • Autonomic Nervous System Diseases / etiology*
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Galvanic Skin Response
  • Humans
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / complications*
  • Non-alcoholic Fatty Liver Disease / diagnostic imaging
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Prevalence
  • Risk Factors
  • Ultrasonography