Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.
Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Korea.
Clin Mol Hepatol. 2022 Jul;28(3):510-521. doi: 10.3350/cmh.2021.0332. Epub 2022 Mar 17.
BACKGROUND/AIMS: Accumulating evidence suggests a link between non-alcoholic fatty liver disease (NAFLD) and brain health. However, population-based evidence on the association between NAFLD and dementia remains unclear. This study was conducted to determine the association between NAFLD and incident dementia.
The study population included 608,994 adults aged ≥60 years who underwent health examinations between 2009 and 2010. Data were collected from the Korean National Health Insurance Service database. NAFLD was assessed using the fatty liver index (FLI). A Cox proportional hazards regression model was used to determine the association between NAFLD and dementia.
During the 6,495,352 person-years of follow-up, 48,538 participants (8.0%) developed incident dementia. The participants were classified into low (FLI <30), intermediate (FLI ≥30 and <60), and high (FLI ≥60) groups. In the overall study population, the FLI groups were associated with a risk of dementia (P for trend <0.001). After propensity score matching, a low FLI was associated with a reduced risk of dementia (adjusted hazard ration [aHR], 0.96; 95% confidence interval [CI], 0.93-0.98; P=0.002), whereas a high FLI (NAFLD) was associated with an increased risk of dementia (aHR, 1.05; 95% CI, 1.02-1.08; P=0.001). A higher risk of dementia in the high FLI group than in the intermediate FLI group was attributed to Alzheimer's disease (aHR, 1.04; 95% CI, 1.01-1.07; P=0.004) rather than vascular dementia (aHR, 0.94; 95% CI, 0.75-1.18; P=0.602).
NAFLD was associated with an increased risk of dementia, which was attributed to an increased risk of Alzheimer's disease.
背景/目的：越来越多的证据表明非酒精性脂肪肝（NAFLD）与大脑健康之间存在关联。然而，人群中关于 NAFLD 与痴呆症之间关联的证据尚不清楚。本研究旨在确定 NAFLD 与痴呆症发病之间的关联。
研究人群包括 608994 名年龄≥60 岁的成年人，他们于 2009 年至 2010 年间接受了健康检查。数据来自韩国国家健康保险服务数据库。使用脂肪肝指数（FLI）评估 NAFLD。采用 Cox 比例风险回归模型确定 NAFLD 与痴呆症之间的关联。
在 6495352 人年的随访期间，有 48538 名参与者（8.0%）发生了痴呆症。参与者被分为低（FLI<30）、中（FLI≥30 且<60）和高（FLI≥60）组。在整个研究人群中，FLI 组与痴呆症发病风险相关（趋势 P<0.001）。在倾向评分匹配后，低 FLI 与痴呆症发病风险降低相关（调整后的危险比[aHR]，0.96；95%置信区间[CI]，0.93-0.98；P=0.002），而高 FLI（NAFLD）与痴呆症发病风险增加相关（aHR，1.05；95%CI，1.02-1.08；P=0.001）。高 FLI 组比中 FLI 组痴呆症发病风险更高，这归因于阿尔茨海默病（aHR，1.04；95%CI，1.01-1.07；P=0.004）而非血管性痴呆（aHR，0.94；95%CI，0.75-1.18；P=0.602）。
NAFLD 与痴呆症发病风险增加相关，这归因于阿尔茨海默病发病风险增加。
