Exploring factors associated with non-alcoholic fatty liver disease using longitudinal MRI

BMC Gastroenterol. 2024 Jul 23;24(1):229. doi: 10.1186/s12876-024-03300-0.

Abstract

Background: To identify factors associated with non-alcoholic fatty liver disease over a 5-year period.

Methods: Three hundred seven participants, including 165 women, with a mean age of 55.6 ± 12.0 years underwent continuous quantitative MRI of the liver using the proton-density fat fraction (PDFF). The liver's fat fractions were determined at baseline and 5 years later, and the frequency of participants who developed fatty liver disease and potential influencing factors were explored. Based on significant factors, a model was generated to predict the development of fatty liver disease.

Results: After excluding participants with pre-existing fatty liver, the baseline PDFF of 3.1 ± 0.9% (n = 190) significantly increased to 7.67 ± 3.39% within 5 years (p < 0.001). At baseline, age (OR = 1.04, p = 0.006, CI = 1.01-1.07), BMI (OR = 1.11, p = 0.041, CI = 1.01-1.23), and waist circumference (OR = 1.05, p = 0.020, CI = 1.01-1.09) were identified as risk factors. Physical activity was negatively associated (OR = 0.43, p = 0.049, CI = 0.18-0.99). In the prediction model, age, physical activity, diabetes mellitus, diastolic blood pressure, and HDL-cholesterol remained as independent variables. Combining these risk factors to predict the development of fatty liver disease revealed an AUC of 0.7434.

Conclusions: Within a five-year follow-up, one-quarter of participants developed fatty liver disease influenced by the triggering factors of age, diabetes mellitus, low HDL-cholesterol, and diastolic blood pressure. Increased physical activity has a protective effect on the development of fatty liver.

Keywords: Fatty liver; Longitudinal study; Magnetic resonance imaging; Metabolic syndrome.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Exercise
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Longitudinal Studies
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / diagnostic imaging
  • Risk Factors
  • Waist Circumference