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Prog Cardiovasc Dis. 2019 Mar - Apr;62(2):127-134. doi: 10.1016/j.pcad.2019.01.005. Epub 2019 Feb 21.

Non-alcoholic fatty liver disease: Prevalence and all-cause mortality according to sedentary behaviour and cardiorespiratory fitness. The HUNT Study.

Author information

1
K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Sor Trondelag, Norway; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia. Electronic address: ilaria.croci@ntnu.no.
2
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.
3
K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Sor Trondelag, Norway.
4
K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Sor Trondelag, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
5
Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia.
6
K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Sor Trondelag, Norway; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.

Abstract

PURPOSE:

Sedentary behaviour (SB) and low physical activity (PA) are independently associated with non-alcoholic fatty liver disease (NAFLD). Compared to PA, high cardiorespiratory fitness (CRF) has been associated with a higher protection against all-cause mortality and a number of specific diseases. However, this relationship has not been investigated in NAFLD. This study examined the roles of SB and CRF on: i) the likelihood of having NAFLD in the general population, and ii) the risk of mortality over 9 years within individuals having NAFLD.

METHODS:

A cross-sectional analysis of 15,781 adults (52% female; age range 19-95 years) was conducted. Self-reported SB was divided into tertiles. CRF was estimated using validated non-exercise models, and the presence of NAFLD from the Fatty Liver Index. Adjusted Odds Ratios and 95% Confidence Intervals for NAFLD were estimated using logistic regression analyses. Hazard Ratios for all-cause mortality were estimated using Cox proportional hazard regression in individuals with NAFLD.

RESULTS:

For each additional 1 h/d of SB, the likelihood of having NAFLD was significantly increased by 4% (CI, 3-6%). In combined analyses, compared with the reference group [high CRF and low (≤4 h/d) SB], individuals with low CRF had a markedly higher likelihood of having NAFLD (OR, 16.9; CI 12.9-22.3), even if they had SB ≤ 4 h/d. High CRF attenuated the negative role of SB up to 7 h/d on NAFLD. Over 9.4 ± 1.3 years of follow-up, individuals with NAFLD and low CRF had the risk of mortality increased by 52% (CI, 10-106%) compared to those with high CRF, regardless of SB or meeting PA guidelines.

CONCLUSIONS:

Low CRF increases the risk of premature death in individuals with NAFLD, and is strongly associated with higher likelihood of having NAFLD, outweighing the influence of SB.

KEYWORDS:

Exercise; Hepatic steatosis; Peak oxygen consumption; Physical activity; Prevention; Sitting

PMID:
30796942
DOI:
10.1016/j.pcad.2019.01.005
[Indexed for MEDLINE]

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