Neglected features of lifestyle: Their relevance in non-alcoholic fatty liver disease

Table 1 Differences between non-alcoholic-fatty-liver-disease and control patients

	NAFLD (n = 532)	Controls (n = 667)	P vaule
Age, yr	48.11 ± 9.00	48.60 ± 8.70	0.343
Systolic blood pressure (mmHg)	124.53 ± 9.71	121.21 ± 10.80	< 0.0001
Diastolic blood pressure (mmHg)	78.84 ± 6.72	76.50 ± 6.73	< 0.0001
BMI, kg/m2	30.49 ± 5.55	24.44 ± 3.72	< 0.0001
HOMA	2.89 ± 1.76	1.80 ± 1.28	< 0.0001
eGFR	82.49 ± 14.15	82.15 ± 17.44	0.714
Total cholesterol, mg/dL	205.17 ± 37.16	207.09 ± 38.82	0.387
HDL cholesterol, mg/dL	51.67 ± 15.85	61.45 ± 16.41	< 0.0001
Triglycerides, mg/dL	109.08 ± 42.41	95.23 ± 58.59	< 0.0001
LDL cholesterol, mg/dL	131.98 ± 33.45	126.59 ± 37.29	0.009
γ-GT (U/L)	33.24 ± 29.40	26.03 ± 21.95	< 0.0001
AST (U/L)	20.77 ± 5.91	21.01 ± 7.10	0.530
ALT (U/L)	15.65 ± 4.60	10.40 ± 4.88	< 0.0001
Alkaline phosphatase (U/L)	68.37 ± 18.49	72.75 ± 43.42	0.030
Serum albumin (g/dL)	4.62 ± 0.39	4.53 ± 0.40	< 0.0001
Lifestyle items
AMDS	32.21 ± 0.91	34.91 ± 0.61	< 0.0001
Baecke - physical activity total score	39.82 ± 3.60	41.43 ± 3.32	< 0.0001
Western diet score	22.84 ± 7.87	12.73 ± 2.48	< 0.0001
Sun exposure score	31.43 ± 3.89	35.73 ± 5.25	< 0.0001
Sleep hours	7.86 ± 1.31	7.90 ± 1.23	0.552

BMI: Body mass index; HOMA-IR: Homoeostasis model insulin resistance; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; γ-GT: γ-glutamyl transpeptidase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; AMDS: Adherence mediterranean diet score; NAFLD: Non-alcoholic-fatty-liver-disease; eGFR: Estimated glomerular filtration rate.

Table 2 Pearson’s χ² and odds ratio

	NAFLD	Controls	χ2	P value	OR	95%CI
BMI ≥ 26.40	408	167	316.3851	< 0.0001	9.851	7.546-12.861
BMI < 26.40	124	500
HOMA ≥ 1.87	368	211	167.0111	< 0.0001	4.849	3.792-6.202
HOMA < 1.87	164	456
HDL ≥ 54.50	204	400	55.3581	< 0.0001	0.415	0.329-0.524
HDL < 54.50	328	267
TGL ≥ 94	324	240	73.7751	< 0.0001	2.771	2.191-3.506
TGL < 94	208	427
AMDS ≥ 34	32	650	1008.8311	< 0.0001	0.002	0.001-0.003
AMDS < 34	500	17
BAECKE ≥ 41.5	181	354	43.4681	< 0.0001	0.456	0.360-0.577
BAECKE < 41.5	351	313
WDS ≥ 15.5	399	97	445.9811	< 0.0001	17.629	13.174-23.590
WDS < 15.5	133	570
SES ≥ 34.5	111	348	122.7881	< 0.0001	0.242	0.187-0.313
SES < 34.5	421	319
Sleep hours ≥ 8	319	370	2.5921	0.107	1.210	0.959-1.527
Sleep hours < 8	208	292

¹Indicates the thresholds calculated by ROC analysis used as cut-offs for comparison between groups with lower measures (BMI, HOMA, AMDS, WDS, SES, BAECKE) vs groups with greater measures. BMI: Body mass index; HOMA-IR: Homoeostasis model insulin resistance; HDL: High-density lipoprotein; TGL: Triglycerides; AMDS: Adherence to mediterranean diet score; WDS: Western diet score; SES: Sun Exposure Score; BAECKE: Baecke’s physical activity questionnaire total score.

Table 3 Multiple linear regression of variables

Predictors	R	R2	F	Sig.	β	P value
	0.965	0.932	2309.1	< 0.0001
BMI, kg/m2					-0.448	< 0.0001
HOMA					-0.393	< 0.0001
AMDS					-1.398	< 0.0001
Baecke					-0.074	< 0.0001
WDS					0.069	< 0.0001
Sun exposure score					-0.044	< 0.0001
Sleep hours					-0.008	0.296

Weighted Least Squares Regression - Weighted by Age. Baecke’s physical activity questionnaire total score and sleep hours vs the severity of NAFLD (included in this analysis as a categorical variable with all 3 severity grades), assessed by ultrasound as bright liver score. BMI: Body mass index; HOMA-IR: Homoeostasis model insulin resistance; AMDS: Adherence to mediterranean diet score; WDS: Western diet score; NAFLD: Non-alcoholic-fatty-liver-disease.