肺功能与非酒精性脂肪肝之间呈负相关：一项观察性和孟德尔随机化研究。

Inverse association between lung function and nonalcoholic fatty liver disease: An observational and mendelian randomization study.

机构信息

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.

出版信息

Nutr Metab Cardiovasc Dis. 2024 Dec;34(12):2705-2712. doi: 10.1016/j.numecd.2024.07.007. Epub 2024 Jul 15.

DOI:10.1016/j.numecd.2024.07.007

PMID:39168802

Abstract

BACKGROUND AND AIM

The association between lung function with non-alcoholic fatty liver disease (NAFLD) in the general population remains unknown. We aimed to examine the association between lung function and NAFLD among the general population in an observational and Mendelian randomization (MR) study.

METHODS AND RESULTS

340, 253 participants without prior liver diseases were included from the UK Biobank. Of these, 30,397 participants had liver proton density fat fraction (PDFF) measurements by magnetic resonance image (MRI). Lung function parameters included forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). The primary outcome was the presence of NAFLD, defined as a PDFF greater than 5.5%. The secondary outcome included incident severe NAFLD and severe liver diseases (including liver cirrhosis, liver failure, hepatocellular carcinoma and liver-related death), defined by the International Classification of Disease codes with different data sources. During a media follow-up duration of 9.3 years, 7335 (24.1%) the presence of NAFLD cases were documented. There was an inverse association of FEV1 (% predicted) (Per SD increment, adjusted OR = 0.91, 95%CI: 0.88-0.94) and FVC (% predicted) (Per SD increment, adjusted OR = 0.90, 95%CI: 0.87-0.92) with the presence of NAFLD. Similar results were found for incident severe NAFLD, severe liver disease, liver cirrhosis, liver failure and liver-related death. MR analyses showed that the genetically predicted FEV1 (adjusted OR = 0.63, 95%CI: 0.46-0.87) and FVC (adjusted OR = 0.69, 95%CI: 0.51-0.95) were both inversely associated with the presence of NAFLD.

CONCLUSIONS

There was an inverse causal relationship between lung function and NAFLD in the general population.

摘要

背景与目的

非酒精性脂肪性肝病（NAFLD）与肺功能之间的关系在普通人群中尚不清楚。我们旨在通过观察性和孟德尔随机化（MR）研究来研究普通人群中肺功能与 NAFLD 之间的关系。

方法与结果

从英国生物库中纳入了 340253 名无既往肝脏疾病的参与者。其中，30397 名参与者通过磁共振成像（MRI）进行了肝脏质子密度脂肪分数（PDFF）测量。肺功能参数包括 1 秒用力呼气量（FEV1）和用力肺活量（FVC）。主要结局为存在 NAFLD，定义为 PDFF 大于 5.5%。次要结局包括通过不同数据源的国际疾病分类代码定义的严重 NAFLD 和严重肝脏疾病（包括肝硬化、肝功能衰竭、肝细胞癌和与肝脏相关的死亡）的发生。在 9.3 年的中位随访期间，记录了 7335 例（24.1%）存在 NAFLD 的病例。FEV1（%预计值）（每 SD 增加，调整后的 OR=0.91，95%CI：0.88-0.94）和 FVC（%预计值）（每 SD 增加，调整后的 OR=0.90，95%CI：0.87-0.92）与 NAFLD 的存在呈负相关。对于严重的 NAFLD 、严重的肝脏疾病、肝硬化、肝功能衰竭和与肝脏相关的死亡，也得到了类似的结果。MR 分析表明，遗传预测的 FEV1（调整后的 OR=0.63，95%CI：0.46-0.87）和 FVC（调整后的 OR=0.69，95%CI：0.51-0.95）均与 NAFLD 的存在呈负相关。