Impacts of unfavourable lifestyle factors on biomarkers of liver function, inflammation and lipid status

PLoS One. 2019 Jun 20;14(6):e0218463. doi: 10.1371/journal.pone.0218463. eCollection 2019.


Background: Adopting a healthy lifestyle is associated with prolonged life expectancy. The main modifiable lifestyle-related risk factors are hazardous alcohol drinking, smoking, excess body weight and lack of physical activity. Our aim was to estimate the impact of unfavourable lifestyle factors on abnormalities in laboratory tests reflecting liver status, inflammation and lipid metabolism in a population-based cross-sectional study.

Methods: The study included 22,273 participants (10,561 men, 11,712 women) aged 25-74 years from the National FINRISK Study. Data on alcohol use, smoking, body weight, and physical activity were recorded from structured interviews. The risk scores for the various life style factors were established on a 0-8 scale and used to stratify the population in classes to allow estimates of their joint effects. Serum liver enzymes (GGT, ALT), C-reactive protein (CRP) and lipid profiles were measured using standard laboratory techniques.

Results: Consistent dose-response relationships were observed between the number of unfavourable risk factors and serum levels of GGT, ALT, CRP, cholesterol, HDL, LDL and triglycerides (p < 0.0005 for linear trend in all comparisons). When compared with those with zero risk factors, the multivariable-adjusted odds ratios (ORs) for abnormalities in all biomarkers were significantly higher in those with a sum of risk score two or more. The most striking increases in ORs in the group with the highest numbers of risk factors were observed among men in serum GGT: 26.6 (12.4-57.0), ALT: 40.3 (5.3-307.8), CRP: 16.2 (7.8-33.7) and serum triglycerides: 14.4 (8.6-24.0).

Conclusions: The data support the view that the presence of unfavourable life style risk factors is associated with distinct abnormalities in laboratory tests for liver function, inflammation and lipid status. Such biomarkers may prove to be of value in the assessment of interventions aimed at reducing unfavourable risk factors and in helping individuals in long-term maintenance of lifestyle modifications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects
  • Biomarkers / blood*
  • C-Reactive Protein / metabolism
  • Cholesterol / blood
  • Coffee / adverse effects
  • Exercise
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / epidemiology*
  • Inflammation / pathology
  • Life Style
  • Lipid Metabolism / genetics
  • Lipids / blood*
  • Lipids / genetics
  • Liver / metabolism*
  • Liver / pathology
  • Male
  • Middle Aged
  • Risk Factors
  • Triglycerides / blood


  • Biomarkers
  • Coffee
  • Lipids
  • Triglycerides
  • C-Reactive Protein
  • Cholesterol

Grant support

This work was supported by: Competitive State Research Financing of the Expert Responsibility area of Seinäjoki Central Hospital and University of Tampere, Grant no: VTR 5300/3116 to ON; and by the Finnish Foundation for the Promotion of Laboratory Medicine Grant no 10/2014 to ON. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.