Correlation of non-alcoholic fatty liver disease and depression in an elderly Chinese population

Qian LIAO; Yi ZHENG; Xiufei LIU; Hua QU; Hongting ZHENG

doi:10.16016/j.1000-5404.201704136

您当前的位置：

首页 >

文章列表页 >

Correlation of non-alcoholic fatty liver disease and depression in an elderly Chinese population

Medical Psychology | 更新时间：2026-01-09

- Correlation of non-alcoholic fatty liver disease and depression in an elderly Chinese population
- Journal of Third Military Medical University Vol. 39, Issue 19, Pages: 1954-1959(2017)
- 作者机构：
  
  400037 重庆，第三军医大学新桥医院内分泌科
- 作者简介：
- 基金信息：
  
  the Key Projects of National Key R & D Plan(2016YFC1101100);the General Program of National Natural Science Foundation of China(81471039);the General Program of National Natural Foundation of China(81270893);the Cooperation Fund for Overseas, Hong Kong and Macao Scholars of National Natural Science Foundation of China(81228023)
- DOI：10.16016/j.1000-5404.201704136
  CLC： R195.4;R575.5;R749.41
- Received：26 April 2017，
  
  Revised：2017-07-03，
  
  Published：15 October 2017
- 稿件说明：
移动端阅览
Qian LIAO, Yi ZHENG, Xiufei LIU, et al. Correlation of non-alcoholic fatty liver disease and depression in an elderly Chinese population[J]. Journal of Third Military Medical University, 2017, 39(19): 1954-1959.
DOI：

Qian LIAO, Yi ZHENG, Xiufei LIU, et al. Correlation of non-alcoholic fatty liver disease and depression in an elderly Chinese population[J]. Journal of Third Military Medical University, 2017, 39(19): 1954-1959. DOI： 10.16016/j.1000-5404.201704136.

摘要

目的

探讨中老年人群中非酒精性脂肪肝(non-alcoholic fatty liver disease，NAFLD)与抑郁症的相关性及其潜在的影响因素。

方法

采用整群抽样法于2015-2016年间选取重庆市沙坪坝区45岁以上居民为研究对象。所有受试者进行问卷调查、体格检查并留取血液检测肝肾功能、血脂等生化指标。最终4 970个符合条件的受试者被纳入分析。采用脂肪肝指数(fatty liver index，FLI)评定非酒精性脂肪肝及其程度，采用患者健康问卷抑郁自评量表(patient health questionnaire，PHQ-9) 评定抑郁症及其程度，分析NAFLD与抑郁症患病风险的相关性及其潜在的影响因素。

结果

在该抽样人群中，轻度和中重度抑郁症的患病率分别为3.3%和1.4%，而在此人群NAFLD患者中，轻度和中重度抑郁症的患病率分别上升至14.2%和51.4%。与非抑郁症相比，抑郁患者(轻度和中重度抑郁)都存在较高的总胆固醇、甘油三酯、低密度脂蛋白、FLI、IL-6水平及糖尿病患病率，并且拥有较低的HDL水平及较少的步行时间(

0.05，

0.01)。多元回归分析发现NAFLD与抑郁症密切相关，且其相关性独立于BMI和是否患有糖尿病，但可以受血脂和炎症指标的影响。

结论

在中老年人群中，NAFLD与抑郁症显著相关，其机制可能与抑郁症所致脂质代谢紊乱和慢性炎症反应有关，而不直接受BMI和糖尿病的调控。

Abstract

Objective

To investigate the correlation of depression with non-alcoholic fatty liver disease (NAFLD) in the Chinese middle-aged and aged population

and explore the possible influencing factors.

Methods

A cross-section study was performed in the 5 321 ≥45-year-old residents living in some communities of Shapingba District

Chongqing during 2014 and 2015. They all received blood tests

anthropometric measurements

and standard questionnaire. Totally 4 970 eligible subjects were finality included for further analysis. NAFLD were assessed by fatty liver index (FLI)

and depression was evaluated by the night-item Patient Health Questionnaire (PHQ-9).

Results

The incidence rate of mild and moderately severe depression was 3.3% and 1.4%

respectively

but the rates increased to 14.2% and 51.4% respectively in the NAFLD patients (

0.001). Compared with non-depressive participants

the depressive patients (including mild and moderately severe depression) had higher levels of total cholesterol (TC)

triglyceride (TG)

low density lipoprotein (LDL)

FLI

interleukin 6 (IL-6)

higher incidence of diabetes

lower high density lipoprotein (HDL)

and shorter walk time. In multiple regressive analysis

depression was closely associated with NAFLD

and the association was independent from body mass index (BMI) and with diabetes or not

but was affected by lipid profiles and inflammatory indicators.

Conclusion

NAFLD is significantly correlated with depression among middle-aged and aged population. The mechanism is related with lipid metabolic disorder and chronic inflammatory reactions

but is independent from obesity and diabetes.

关键词

Keywords

references

LIM J S, MIETUS-SNYDER M, VALENTE A, et al . The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome[J ] . Nat Rev Gastroenterol Hepatol, 2010, 7(5): 251-264.DOI:10.1038/nrgastro.2010.41.

TAMURA Y, SATO F, KAWAM OR I R. Metabolic syndrome and NAFLD/NASH[J]. Nihon Rinsho, 2006, 64(Suppl 9):449-452.

HÛLEK P, DRESSLEROVÁI. Metabolic syndrome and the liver (NAFLD/NASH)[J]. Vnitr Lek, 2009, 55(7/8): 646-649.

ADAMS L A, WATERS O R, KNUIMAN M W, et al . NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study[J ] . Am J Ga stroenterol, 2009, 104(4): 861-867. DOI:10.1038/ajg.2009.67.

REYES R B. NAFLD and metabolic syndrome a troublesome association[J]. Rev Gastroenterol Mex, 2006, 71(4): 510-511.

MARTINEZ H F, TOVILLA Z C, LOPEZ N L, et al . Prevalence and gravity of depression and anxiety in patients with obesity and type 2 diabetes: a study in the population of Tabasco, Mexico[J ] . Gac Med Mex, 2014, 150(Suppl 1): 101-106.

UCHIL D, PIPALIA D, CHAWLA M, et al . Non-alcoholic fatty liver disease (NAFLD)-the hepatic component of metabolic syndrome[J ] . J Assoc Physicians India, 2009, 57: 201-204.

BLAZER D G, MOODY-AYERS S, CRAFT-M OR GAN J, et al . Depression in diabetes and obesity: racial/ethnic/gender issues in older adults[J ] . J Psychosom Res, 2002, 53(4): 913-916. DOI:10.1016/s0022-3999(02)00314-8.

DE L A CRUZ-CANO E, TOVILLA-ZARATE C A, REYES-RAMOS E, et al . Association between obesity and depression in patients with diabetes mellitus type 2; a study protocol[J ] . F1000Res, 2015, 4: 7. DOI:10.12688/f1000research.5995.1.

ATLANTIS E. Obesity and increased risk of type 2 diabetes mellitus: The aetiological role of depression[J]. Obes Res Clin Pract, 2012, 6(3): e175-e262. DOI:10.1016/j.orcp.2012.06.004.

GREEN A J, BAZATA D D, FOX K M, et al . Quality of Life, Depression, and Healthcare Resource Utilization among Adults with Type 2 Diabetes Mellitus and Concomitant Hypertension and Obesity: A Prospective Survey[J ] . Cardiol Res Pract, 2012, 2012: 404107. DOI:10.1155/2012/404107.

STREKALOVA T, EVANS M, COSTA-NUNES J, et al . Tlr4 upregulation in the brain accompanies depression-and anxiety-like behaviors induced by a high-cholesterol diet[J ] . Brain Behav Immun, 2015, 48: 42-47. DOI:10.1016/j.bbi.2015.02.015.

POPOVIC' D D J, C'ULAFIC' D M, TEPAVCˇEVIC' D B, et al . Assessment of depression and anxiety in patients with chronic liver disease[J ] . Vojnosanit Pregl, 2015, 72(5): 414-420. DOI:10.2298/vsp130904007p.

LEE K, OTGONSUREN M, YOUNOSZAI Z, et al . Association of chronic liver disease with depression: a population-based study[J ] . Psychosomatics, 2013, 54(1): 52-59. DOI:10.1016/j.psym.2012.09.005.

LE STRAT Y, LE FOLL B, DUBERTRET C. Major depression and suicide attempts in patients with liver disease in the United States[J]. Liver Int, 2015, 35(7): 1910-1916. DOI:10.1111/liv.12612.

WEINSTEIN A A, KALLMAN PRICE J, STEPANOVA M, et al . Depression in patients with nonalcoholic fatty liver disease and chronic viral hepatitis B and C[J ] . Psychosomatics, 2011, 52(2): 127-132. DOI:10.1016/j.psym.2010.12.019.

PAIS R, RUSU E, ZILISTEANU D, et al . Prevalence of steatosis and insulin resistance in patients with chronic hepatitis B compared with chronic hepatitis C and non-alcoholic fatty liver disease[J ] . Eur J Intern Med, 2015, 26(1): 30-36. DOI:10.1016/j.ejim.2014.12.001.

QU H, WANG H, DENG M, et al . Associations between longer habitual day napping and non-alcoholic fatty liver disease in an elderly Chinese population[J ] . PLoS ONE, 2014, 9(8): e105583. DOI:10.1371/journal.pone.010 5583.

SPITZER R L, KROENKE K, WILLIAMS J B. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire[J]. JAMA, 1999, 282(18): 1737-1744.DOI:10.1001/jama.282.18.1737.

OLVERA R L, WILLIAMSON D E, FISHER-HOCH S P, et al . Depression, obesity, and metabolic syndrome: prevalence and risks of comorbidity in a population-based representative sample of Mexican Americans[J ] . J Clin Psychiatry, 2015, 76(10): e1300-e1305. DOI:10.4088/JCP.14m09118.

OPEL N, REDLICH R, GROTEGERD D, et al . Obesity and major depression: Body-mass index (BMI) is associated with a severe course of disease and specific neurostructural alterations[J ] . Psychoneuroendocrinology, 2015, 51:219-226.DOI:10.1016/j.psyneuen.2014.10.001.

LIN K P, LIANG T L, LIAO I C, et al . Associations among depression, obesity, and metabolic syndrome in young adult females[J ] . Biol Res Nurs, 2014, 16(3): 327-334. DOI:10.1177/1099800413500138.

JUN E M, CHOI S B. Obesity, Body Image, Depression, and Weight-control Behaviour Among Female University Students in Korea[J]. Journal of Cancer Prevention, 2014, 19(3): 240-246. DOI:10.15430/jcp.2014.19.3.240.

HAMMERTON G, THAPAR A, THAPAR A K. Association between obesity and depressive disorder in adolescents at high risk for depression[J]. Int J Obes (Lond), 2014, 38(4): 513-519. DOI:10.1038/ijo.2013.133.

HASAN S S, CLAVARINO A M, MAMUN A A, et al . Population impact of depression either as a risk factor or consequence of type 2 diabetes in adults: a meta-analysis of longitudinal studies[J ] . Asian J Psychiatr, 2013, 6(6): 460-472. DOI:10.1016/j.ajp.2013.09.008.

CHEN P C, CHAN Y T, CHEN H F, et al . Population-based cohort analyses of the bidirectional relationship between type 2 diabetes and depression[J ] . Diabetes Care, 2013, 36(2): 376-382. DOI:10.2337/dc12-0473.

TESSARI P, C OR A CI NA A, COSMA A, et al . Hepatic lipid metabolism and non-alcoholic fatty liver disease[J ] . Nutr Metab Cardiovasc Dis, 2009, 19(4): 291-302. DOI:10.1016/j.numecd.2008.12.015.

MA K L, RUAN X Z, POWIS S H, et al . Inflammatory stress exacerbates lipid accumulation in hepatic cells and fatty livers of apolipoprotein E knockout mice[J ] . Hepatology, 2008, 48(3): 770-781. DOI:10.1002/hep.22423.

LEHTO S M, RUUSUNEN A, NISKANEN L, et al . Elev ated depressive symptoms and compositional changes in LDL particles in middle-aged men[J ] . Eur J Epidemiol, 2010, 25(6): 403-409. DOI:10.1007/s10654-010-9457-1.

LEHTO S M, NISKANEN L, TOLMUNEN T, et al . Low serum HDL-cholesterol levels are associated with long symptom duration in patients with major depressive disorder[J ] . Psychiatry Clin Neurosci, 2010, 64(3): 279-283. DOI:10.1111/j.1440-1819.2010.02079.x.

DUARTE N, COELHO I C, PATARRÃO R S, et al . How Inflammation Impinges on NAFLD: A Role for Kupffer Cells[J ] . BioMed Research International, 2015, 2015: 1-11. DOI:10.1155/2015/984578.

VALKANOVA V, EBMEIER K P, ALLAN C L. CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies[J]. J Affect Disord, 2013, 150(3): 736-744. DOI:10.1016/j.jad.2013.06.004.

MUSSELMAN D L, MILLER A H, PORTER M R, et al . Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings[J ] . Am J Psychiatry, 2001, 158(8): 1252-1257. DOI:10.1176/appi.ajp.158.8.1252.

RODEN M. Mechanisms of Disease: hepatic steatosis in type 2 diabetes—pathogenesis and clinical relevance[J]. Nat Clin Pract Endocrinol Metab, 2006, 2(6): 335-348. DOI:10.1038/ncpendmet0190.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

p300 promotes hepatic lipid accumulation in dyslipidemia by regulating SREBP-1c acetylation

Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification: A NHANES-based cross-sectional study uncovering its protective threshold

Naringin improves lipopolysaccharide-induced depression-like behaviors in mice

Development and validation of interpretation bias questionnaire with ambiguous scenarios

A brain network model for depression: negative affective processing and cognitive control

Related Author

NUHU Abdul-Rauf Nyewneh

LI Xiaoli

FANG Lu

CAI Yongqing

CHEN Fei

YUAN Lie

YANG Xiong

JIANG Qingsong

Related Institution

College of Pharmacy，Chongqing Medical University

Department of Gastrointestinal Surgery，the First Affiliated Hospital of Chongqing Medical University

Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology，Chongqing；⁴Department of Pharmacy，Daping Hospital，Army Medical University （Third Military Medical University）， Chongqing； ⁵Department of Pharmacy，Dazhou Hospital of Integrated Traditional Chinese and Western Medicine

陆军军医大学大坪医院药剂科

达州市中西医结合医院药学科

⁰