Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Health Care, Yodogawa Christian Hospital, Osaka, Japan.
Kobe J Med Sci. 2020 Nov 17;66(3):E102-E112.
Cigarette smoking is known to be a significant risk factor associated with non-alcoholic fatty liver disease (NAFLD). We aimed to examine the association between smoking status and the severity of fatty liver with regard to sex and smoking cessation.
In total, 13,466 subjects (6,642 males and 6,824 females) who had undergone abdominal ultrasonography for health check-up, multivariable logistic regression analysis was retrospectively conducted to assess the association between smoking status and the prevalence of NAFLD stratified by sex after adjusting for other potential confounders.
Male sex (odds ratio [OR] 3.27, 95% confidence interval [CI] 3.00-3.57) and smoking history (former smoker: OR 1.23, 95% CI 1.10-1.38, current smoker: OR 1.31, 95% CI 1.17-1.47) were significantly associated with NAFLD. In males with a smoking history, an increased pack-year was strongly associated with the prevalence and severity of NAFLD (prevalence of moderate to severe fatty liver: Pack-year from 0.01 to 9.99, 21.3%; Pack-year from 10.00 to 19.99, 27.2%; Pack-year ≥20.00, 33.7%; P<0.0001), although the prevalence of moderate to severe fatty liver was inversely associated with the duration of smoking cessation (more than 10 years vs. within 5 years, OR 0.71, 95% CI 0.53-0.96). In female subjects, light current smoking was negatively associated with NAFLD (current smoker with a pack-year from 0.01 to 9.99 vs. never smoker, OR 0.41, 95% CI 0.19-0.76).
Smoking status and pack-year were strongly associated with the prevalence and severity of NAFLD, especially in Japanese males. However, smoking cessation improved NAFLD in this population.
吸烟是与非酒精性脂肪性肝病（NAFLD）相关的重要危险因素。我们旨在研究吸烟状况与脂肪肝严重程度之间的关系，以及这种关系在性别和戒烟方面的表现。
共纳入 13466 例（男 6642 例，女 6824 例）因健康体检而行腹部超声检查的受试者，采用多变量 logistic 回归分析，在调整其他潜在混杂因素后，按性别对吸烟状况与 NAFLD 患病率进行分层分析。
男性（比值比[OR]3.27，95%置信区间[CI]3.00-3.57）和吸烟史（曾吸烟者：OR 1.23，95%CI 1.10-1.38；现吸烟者：OR 1.31，95%CI 1.17-1.47）与 NAFLD 显著相关。在有吸烟史的男性中，吸烟包年数与 NAFLD 的患病率和严重程度呈正相关（中重度脂肪肝患病率：吸烟包年数 0.01-9.99 年，21.3%；吸烟包年数 10.00-19.99 年，27.2%；吸烟包年数≥20.00 年，33.7%；P<0.0001），尽管中重度脂肪肝的患病率与戒烟时间呈负相关（戒烟 10 年以上 vs. 5 年内，OR 0.71，95%CI 0.53-0.96）。在女性受试者中，轻度现吸烟与 NAFLD 呈负相关（吸烟包年数 0.01-9.99 年的现吸烟者与从不吸烟者相比，OR 0.41，95%CI 0.19-0.76）。
吸烟状况和吸烟包年数与 NAFLD 的患病率和严重程度密切相关，尤其是在日本男性中。然而，在该人群中，戒烟可改善 NAFLD。
