Smoking and the Risk of Non-Alcoholic Fatty Liver Disease: A Cohort Study
Smoking and the Risk of Non-Alcoholic Fatty Liver Disease: A Cohort Study
复制标题
DOI：
10.1038/s41395-018-0283-5
复制
发表时间：
2019-03-01
影响因子：
9.8
通讯作者：
Ryu, Seungho
中科院分区：
文献类型：
--
作者：
Jung, Hyun-Suk;Chang, Yoosoo;Ryu, Seungho
结论：吸烟在非酒精性脂肪性肝病（NAFLD）发展中的作用仍然存在争议。我们根据吸烟状况和尿可替宁水平评估了NAFLD事件的风险。方法：我们对199,468名基线无NAFLD的韩国成年人进行了队列研究，他们每年或每两年进行一次随访，中位数为4.1年。使用超声确定脂肪肝的存在。NAFLD的严重程度通过NAFLD纤维化评分（NFS）进行评估，NFS是一种非侵入性纤维化标记物。结果：在1，070，991人-年的随访中，45，409名参与者发生了NAFLD。自我报告的当前吸烟，包年，和尿可替宁水平与NAFLD风险增加显著相关。对于男性，多变量调整的风险比（aHR）发生NAFLD的95%置信区间（CI）为10-19.9，20包-年与0包-年的比较为1.25（1.21- 1.29）和1.36（1.30-1.42）;对于女性，NAFLD的aHR（95% CI）比较5-9.9和10包-年与0包-年分别为1.25（1.04-1.50）和1.46（1.17-1.81）。吸烟包年也与NAFLD风险增加以及中等或高纤维化评分相关。对于男性，20包-年与0包-年相比，NAFLD+中度或高度NFS的aHR（95% CI）为1.29（1.18-1.42）;对于女性，10包年与0包年相比的aHR（95% CI）为1.75（1.12-2.73）.结论：在一个大的青年和中年男性和女性队列中，目前吸烟，包年，尿可替宁水平与NAFLD发生风险呈正相关，表明吸烟有助于NAFLD的发展。
OBJECTIVES:The role of smoking in the development of non-alcoholic fatty liver disease (NAFLD) remains controversial. We assessed the risk of incident NAFLD according to smoking status and urinary cotinine levels.METHODS:We performed a cohort study of 199,468 Korean adults without NAFLD at baseline who were followed annually or biennially for a median of 4.1 years. The presence of fatty liver was determined using ultrasound. NAFLD severity was assessed using NAFLD fibrosis score (NFS), a non-invasive fibrosis marker.RESULTS:During 1,070,991 person-years of follow-up, 45,409 participants developed NAFLD. Self-reported current smoking, pack-years, and urinary cotinine level were significantly associated with increased risk for NAFLD. For men, the multivariable-adjusted hazard ratios (aHR) (95% confidence intervals (CI)) for incident NAFLD comparing 10-19.9, and 20 pack-years to 0 pack-years were 1.25 (1.21- 1.29), and 1.36 (1.30-1.42), respectively; for women, aHR (95% CI) for NAFLD comparing 5-9.9, and 10 pack-years to 0 pack-years were 1.25 (1.04-1.50), and 1.46 (1.17-1.81), respectively. Smoking pack-years were also associated with increased risk for NAFLD plus intermediate or high fibrosis score. For men, the aHR (95% CI) for NAFLD plus intermediate or high NFS comparing 20 pack-years to 0 pack-years was 1.29 (1.18-1.42); for women, the aHR (95% CI) comparing 10 pack-years to 0 pack-years was 1.75 (1.12-2.73).CONCLUSIONS:In a large cohort of young and middle-aged men and women, current smoking, pack-years, and urinary cotinine levels were positively associated with the risk of incident NAFLD, suggesting that smoking contributes to the development of NAFLD.