Lyu Young Sang, Yoon Youngmin, Kim Jin Hwa, Kim Sang Yong
Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea.
Division of Nephrology, Department of Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju 61453, Republic of Korea.
Medicina (Kaunas). 2025 Sep 19;61(9):1711. doi: 10.3390/medicina61091711.
: Hepatic steatosis is associated with an increased risk of liver-related morbidity and mortality. Although numerous studies have reported associations between depression, obesity, metabolic syndrome, and cardiovascular disease, the relationship between depression and hepatic steatosis has not yet been fully elucidated. Moreover, obesity is a shared risk factor for hepatic steatosis and depression; however, few studies have adequately adjusted for obesity as a potential confounder. In this study, we investigated the association between depression and hepatic steatosis stratified by obese and non-obese status. : This study used data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare between 2010 and 2019, which was a cross-sectional and nationally representative study of non-institutionalized civilians using a stratified, multistage, clustered probability sampling design. Multivariate logistic regression analyses were conducted to evaluate the association between depression and hepatic steatosis in the groups stratified by obese status. : Of 80,861 participants, data from 45,307 were included in the analysis. The prevalence of non-obese and obese hepatic steatosis was 3.1% and 19.3%, respectively, and the prevalence of diagnosed depression was 4.6%. Individuals with hepatic steatosis showed less favorable metabolic profiles, including higher rates of diabetes and elevated liver enzyme levels. Those with depression were older, predominantly female, and had lower socioeconomic status. After fully adjusting for confounding factors, multivariate logistic regression analysis showed that non-obese hepatic steatosis was significantly associated with an increased risk of depression, and obese hepatic steatosis was significantly associated with suicidal ideation and attempts. : This study suggests a significant association between depression and hepatic steatosis with and without obese status. Given the significant impact of hepatic steatosis on depression outcomes, healthcare providers should screen patients with hepatic steatosis for depression and provide appropriate treatment as needed.
肝脂肪变性与肝脏相关发病和死亡风险增加有关。尽管众多研究报告了抑郁症、肥胖、代谢综合征和心血管疾病之间的关联，但抑郁症与肝脂肪变性之间的关系尚未完全阐明。此外，肥胖是肝脂肪变性和抑郁症的共同危险因素；然而，很少有研究充分将肥胖作为潜在混杂因素进行校正。在本研究中，我们按肥胖和非肥胖状态分层，调查了抑郁症与肝脂肪变性之间的关联。
本研究使用了韩国卫生与福利部在2010年至2019年期间进行的韩国国家健康与营养检查调查的数据，该调查是一项针对非机构化平民的横断面全国代表性研究，采用分层、多阶段、整群概率抽样设计。进行多变量逻辑回归分析，以评估按肥胖状态分层的各组中抑郁症与肝脂肪变性之间的关联。
在80,861名参与者中，45,307人的数据纳入分析。非肥胖和肥胖肝脂肪变性的患病率分别为3.1%和19.3%，诊断为抑郁症的患病率为4.6%。肝脂肪变性患者的代谢指标较差，包括糖尿病发生率较高和肝酶水平升高。抑郁症患者年龄较大，以女性为主，社会经济地位较低。在对混杂因素进行充分校正后，多变量逻辑回归分析显示，非肥胖肝脂肪变性与抑郁症风险增加显著相关，肥胖肝脂肪变性与自杀意念和自杀未遂显著相关。
本研究表明，无论是否肥胖，抑郁症与肝脂肪变性之间均存在显著关联。鉴于肝脂肪变性对抑郁症结局有显著影响，医疗保健提供者应筛查肝脂肪变性患者是否患有抑郁症，并根据需要提供适当治疗。
