| Aims: Nonalcoholic fatty liver disease(NAFLD)is currently a prominent chronic liver disease worldwide,which places a tremendous burden on the health of global populations.Cumulative evidence has suggested that inflammation directly involved in the pathophysiology of NAFLD.Immunoglobulins(Igs)have an important role in immune responses.This study aimed to assess the association of serum levels of Igs with the onset of NAFLD in the general population.Methods: We designed this population-based cohort study.Since 2010,participants who entered the “TCLSIH” cohort(Who signed informed consent.)were recruited and followed up until December 2018.Laboratory tests,physical examinations,questionnaires,and routine blood tests were performed on each subject who recruited from "TCLSIH" cohort.The inclusion criteria were as follows:(1)participants who volunteered to join the“TCLSIH”cohort study from 2010 to 2018;(2)participants who had undergone measurements of serum Igs levels;(3)participants who had undergone measurements of abdominal ultrasound examination.The exclusion criteria were as follows:(1)those with a history of cardiovascular disease;(2)those with a history of cancer;(3)those who did not complete data collection on fatty liver disease;(4)those with alcoholic fatty liver disease;(5)those with other liver diseases(viral hepatitis,autoimmune hepatitis,drug-induced liver disease,liver cancer,etc.);(6)participants who had been previously diagnosed with fatty liver disease;(7)those who did not undergo health examinations during January 2010 to December 2018.The diagnosis of fatty liver was based on the result of real-time ultrasonography using standardized criteria performed by experienced sonographers.Serum levels of immunoglobulins were determined by the immunonephelometric technique.The primary outcome of the study was the onset of NAFLD.The diagnosis of the onset of NAFLD was based on the Chinese Guidelines for the diagnosis and treatment of nonalcoholic fatty liver disease: those diagnosed with fatty liver disease together with a self-reported alcohol consumption of <70 g/week in women and <140 g/week in men,respectively,were defined as having NAFLD.The data collected from January 2010 to December 2018 was statistically analyzed using SAS 9.3 software.In this study,the incidence of NAFLD was the dependent variable,and the baseline quartiles of Igs(IgG,IgE,IgM,and IgA)were used as independent variables.The Cox model was used to investigate the relationship between Igs and the onset of NAFLD.Results: From January 2010 to December 2018,a total of 8,513 participants were underwent health examinations.After following the uniform inclusion and exclusion criteria,the final cohort study population was comprised of 3,439 participants.The mean age was 49.4±10.4 years.The follow-up rate for this cohort study was 81.3%,with a median follow-up of 3 years(range from one to eight years).During the follow-up period,a total of 800 participants were diagnosed with new-onset NAFLD.The incidence of NAFLD is 68/1,000 person-years.After adjusting for the confounding variables,the hazard ratio(95% confidence interval)of NAFLD for increasing quartiles of IgG,IgE,IgM and IgA were 1.00,0.81(0.63,1.05),0.64(0.46,0.90),and 0.51,(0.32,0.82)(P for trend <0.01);1.00,0.91(0.70,1.17),0.80(0.57,1.14)and 0.70(0.40,1.20)(P for trend = 0.43);1.00,1.10(0.85,1.42)),0.92(0.65,1.30)and 1.17(0.72,1.90)(P for trend = 0.52);1.00,0.97(0.75,1.26),0.94(0.67,1.32)and 0.87(0.55,1.35)(P for trend = 0.46).Conclusion: This study indicated that IgG levels are inversely related to the incidence of NAFLD in adults.Decreased IgG may be an independent predictor for developing NAFLD.Increased resources should be devoted to the investigation of NAFLD,especially its pathogenesis and potential therapeutics. |
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