The Relationship Between Lifestyle And Nonalcoholic Fatty Liver Disease

Objectives:To investigate the major risk factors affecting the occurrence and development of NAFLD and the correlation between diet,sleep status and biochemical indicators by providing questionnaires and laboratory tests,so as to provide a basis for the prevention and control of NAFLD.Methods:People who went to the physical examination center of xi'an central hospital for physical examination from August 1,2018 to December 1,2018 were selected as research objects,using food frequency questionnaire,the international physical activity questionnaire,social time difference scale,PSQI questionnaire,daytime sleepiness,perceived stress scale questionnaire for the physical examination personnel and gathering Blood routine,liver function,blood lipid and other related laboratory indexes.The main dietary structure types were analyzed by factor analysis.T-test and chi-square test were used to analyze the relationship between general conditions,diet,exercise and sleep and the occurrence and development of NAFLD.Spearman correlation analysis was used to analyze the correlation between sleep and biochemical indicators.Multivariate non-conditional Logistic regression was used to analyze the relationship between general risk factors of NAFLD and nonalcoholic fatty liver disease.Results:1.General survey:a total of 560 subjects were enrolled,including 224 NAFLD patients and 336 healthy controls.Among the NAFLD patients,186 were male and 38were female,with an average age of(42.69±11.89)years old.In the healthy control group,164 males and 172 females,the average age was(38.33±10.98)years old.There was a statistically significant difference between the patients with NAFLD and the healthy control group in gender,age,BMI,marital status,smoking,drinking,whether they had hypertension and diabetes(P<0.05).among which BMI was significantly higher than the healthy control group and mainly concentrated in the overweight range.There was no significant difference in the educational level of NAFLD patients compared with the healthy control group(P>0.05).2.Comparison of concomitant diseases between the two groups:There were statistically significant differences between NAFLD patients and healthy controls in the presence or absence of hypertension and diabetes(P<0.001).3.Type of dietary structure:Factor analysis method was used to obtain the factor loading values of 28 kinds of food.Food with the absolute value of factor loading greater than 0.4 was selected for sorting and analysis.A total of 4 major factors were extracted to reflect the four types of dietary structure.Factor 1 includes:fresh fruit,fungus mushrooms,nuts,eggs,green leafy vegetables,soy products,radish cabbage,potato sweet potatoes,fresh milk,defined as a healthy eating pattern;factor 2 includes:chicken and duck meat,animal offal,pig,beef and mutton Sausage/bacon/bacon,fish,rice,juice drink,cola sprite,defined as meat eating mode;factor 3 includes beer,liquor,red wine,rice wine,tea,defined as drinking mode;factor 4 includes noodles,pickles/pulp,pickles,taro/buns/cake,defined as a traditional diet.Among the four dietary structures,factors1,2,3,and 4 explained the variances of 13.75%,10.31%,6.22%,and 5.91%,respectively.4.Comparison of physical activity level and sedentary time between the two groups:there were no statistically significant differences in sedentary time and physical activity level between the NAFLD group and the healthy control group(P>0.05).5.Comparison of dietary structure between the two groups:There was a statistically significant difference in the meat diet pattern between the NAFLD group and the healthy control group(?~2=14.702,P=0.002).Compared with the healthy control group,the NAFLD group had a statistically significant difference in healthy diet patterns(?~2=8.274,P=0.041).There was no significant difference in drinking mode between the NAFLD group and the healthy control group(P>0.05).There was no significant difference between the traditional diet mode of the NAFLD group and the healthy control group(P>0.05).6.Two groups of laboratory indexes comparison:NAFLD group hemoglobin(Hb),white blood cells(WBC),fasting blood glucose(FBG),alanine aminotransferase(ALT),aspertate aminotransferase(AST),glutamine transferase(GGT),low density lipoprotein(LDL),total cholesterol(TC),triglycerides(TG)are higher than that of normal control group,high density cholesterol(HDL)is lower than the control group,the difference had statistical significance(P<0.001);Platelet(PLT)and albumin(ALB)were not statistically significant(P>0.05).7.Comparison of sleep and stress perception between the two groups:The sleep quality PSQI score,the daytime sleepiness ESS score,and the social jet lag in the NAFLD group were all higher than those in the control group,and the difference was statistically significant(P<0.05).The sleep time of the NAFLD group was lower than that of the healthy control group,and the difference was statistically significant(P<0.05);Compared with the healthy control group,the NAFLD group had no statistically significant difference in pressure perception score(?~2=1.594,P=0.451).8.Correlation analysis of sleep status with biochemical indexes and BMI:social jet lag was positively correlated with WBC,GGT and BMI;Sleep time was negatively correlated with FBG,TG,ALT,GGT and BMI,positively correlated with HDL;PSQI score was positively correlated with FBG.ESS score was positively correlated with WBC,ALT,GGT and BMI.9.Multiple factors of NAFLD unconditioned Logistic regression analysis:To investigate whether people with NAFLD as the dependent variable,with gender,age,BMI,smoking,drinking,hypertension,diabetes,a healthy diet,meat diet,traditional diet,drinking diet,sleep quality,daytime sleepiness,perceived stress,sleep time,social jet lag,sedentary time as the independent variables into the multivariate logistic regression analysis.The analysis results showed that women,overweight and obesity,diabetes,drinking diet pattern,and poor sleep quality entered the regression equation.Women and drinking diet pattern were protective factors,and their relative risk OR value and 95%confidenceinterval were 0.208(0.080-0.545)and 0.187(0.061-0.568),respectively.Overweight or obesity,diabetes and poor sleep quality were risk factors,and their relative OR values and 95%confidence intervals were 30.323(13.079-70.302),32.834(2.759-390.729)and 2.018(1.003-4.059),respectively.Conclusions:1.There were gender differences in the prevalence of NAFLD with more males than females.2.Smoking,drinking,hypertension,and diabetes are all related to the pathogenesis of NAFLD.3.The meat eating mode is related to the development of NAFLD.4.Social jet lag,daytime sleepiness,short sleep and poor sleep quality were related to the onset of NAFLD,and showed a linear correlation with BMI,white blood cells,blood lipids,fasting blood glucose and liver enzymes.5.Multivariate analysis found that overweight/obesity,diabetes,and poor sleep quality were the major risk factors for NAFLD.