Xu Wei-Ming, Zhang Hai-Fu, Feng Yong-Hang, Li Shuo-Jun, Xie Bi-Yun
Department of Medicine, The First People's Hospital of Fuyang, Hangzhou 311400, Zhejiang Province, China.
Department of Internal Medicine, The First People's Hospital of Fuyang, Hangzhou 311400, Zhejiang Province, China.
World J Clin Cases. 2024 May 16;12(14):2359-2369. doi: 10.12998/wjcc.v12.i14.2359.
Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ArLD) constitute the primary forms of chronic liver disease, and their incidence is progressively increasing with changes in lifestyle habits. Earlier studies have documented a correlation between the occurrence and development of prevalent mental disorders and fatty liver.
To investigate the correlation between fatty liver and mental disorders, thus necessitating the implementation of a mendelian randomization (MR) study to elucidate this association.
Data on NAFLD and ArLD were retrieved from the genome-wide association studies catalog, while information on mental disorders, including Alzheimer's disease, schizophrenia, anxiety disorder, attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, multiple personality disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and schizophrenia was acquired from the psychiatric genomics consortium. A two-sample MR method was applied to investigate mediators in significant associations.
After excluding weak instrumental variables, a causal relationship was identified between fatty liver disease and the occurrence and development of some psychiatric disorders. Specifically, the findings indicated that ArLD was associated with a significantly elevated risk of developing ADHD (OR: 5.81, 95%CI: 5.59-6.03, < 0.01), bipolar disorder (OR: 5.73, 95%CI: 5.42-6.05, = 0.03), OCD (OR: 6.42, 95%CI: 5.60-7.36, < 0.01), and PTSD (OR: 5.66, 95%CI: 5.33-6.01, < 0.01). Meanwhile, NAFLD significantly increased the risk of developing bipolar disorder (OR: 55.08, 95%CI: 3.59-845.51, < 0.01), OCD (OR: 61.50, 95%CI: 6.69-565.45, < 0.01), and PTSD (OR: 52.09, 95%CI: 4.24-639.32, < 0.01).
Associations were found between genetic predisposition to fatty liver disease and an increased risk of a broad range of psychiatric disorders, namely bipolar disorder, OCD, and PTSD, highlighting the significance of preventive measures against psychiatric disorders in patients with fatty liver disease.
非酒精性脂肪性肝病（NAFLD）和酒精性肝病（ArLD）是慢性肝病的主要形式，其发病率随着生活方式的改变而逐渐增加。早期研究已记录了常见精神障碍的发生发展与脂肪肝之间的相关性。
研究脂肪肝与精神障碍之间的相关性，因此有必要开展孟德尔随机化（MR）研究以阐明这种关联。
从全基因组关联研究目录中检索NAFLD和ArLD的数据，而包括阿尔茨海默病、精神分裂症、焦虑症、注意力缺陷多动障碍（ADHD）、双相情感障碍、重度抑郁症、多重人格障碍、强迫症（OCD）、创伤后应激障碍（PTSD）和精神分裂症在内的精神障碍信息则从精神疾病基因组学联盟获取。应用两样本MR方法研究显著关联中的中介因素。
在排除弱工具变量后，确定了脂肪性肝病与某些精神障碍的发生发展之间存在因果关系。具体而言，研究结果表明，ArLD与患ADHD（比值比：5.81，95%置信区间：5.59 - 6.03，P < 0.01）、双相情感障碍（比值比：5.73，95%置信区间：5.42 - 6.05，P = 0.03）、OCD（比值比：6.42，95%置信区间：5.60 - 7.36，P < 0.01）和PTSD（比值比：5.66，95%置信区间：5.33 - 6.01，P < 0.01）的风险显著升高相关。同时，NAFLD显著增加了患双相情感障碍（比值比：55.08，95%置信区间：3.59 - 845.51，P < 0.01）、OCD（比值比：61.50，95%置信区间：6.69 - 565.45，P < 0.01）和PTSD（比值比：52.09，95%置信区间：4.24 - 639.32，P < 0.01）的风险。
发现脂肪性肝病的遗传易感性与一系列精神障碍（即双相情感障碍、OCD和PTSD）风险增加之间存在关联，突出了对脂肪性肝病患者预防精神障碍措施的重要性。
