| Objectives To investigate the prevalence and morbidity of nonalcoholic fatty liver disease(NAFLD)in Jinchang cohort,explore influence factors of NAFLD,especially the effects of dietary habits and obesity on the prevalence and morbidity of NAFLD,in order to provide theoretical basis for prevention and control of NAFLD,and give scientific data for the epidemiological study of NAFLD in our country.Methods Baseline data,which included epidemiology investigation,physical examination and blood biochemical examination,was collected from current and former employees between June 2011 to December 2013.General demographic characteristics,dietary habits,professional behavior characteristics,past medical history,physiological and biochemical indexes were all gathered.The follow-up process was completed between January 2014 and November 2015,with an average follow-up period of 2.2 years.A cross-sectional study was made to understand the prevalence of NAFLD.A case-control study and logistic regression model were used to explore effects of diet style and obesity on the prevalence of NAFLD,while prospective cohort study and Cox regression model were carried out to analyze the relationship of diet and obesity to NAFLD.Results 1.The prevalence of NAFLD was 17.11% in Jinchang cohort,and the prevalence of males was higher than that of females(19.09% VS 14.05%,P<0.05).The prevalence of total population was increased first and then decreased with the increasing of age,which reached its peak in the group of 55 ～(20.84%).The prevalence of males was also increased first and then decreased with the increasing of age,which reached its peak in the group of 25 ～(20.60%).The prevalence of females was increased with the increasing of age,which reached its peak in the group of ≥75(27.76%).The prevalence of males was high than that of females before the age of 50,while the prevalence of females was high than that of males after 50 years old.The prevalence of NAFLD,which was highest in the obesity in total,men and women(45.73%,45.13% and 47.05% respectively),was increased with the increasing of BMI.The prevalence of NAFLD was increased with the rising of waist circumference and waist-to-height ratio.2.The cumulative incidence of NAFLD in Jinchang cohort was 6.69%,and the incidence of males was high than that of females(7.42% VS 6.23%,P<0.05).The incidence of total population was increased first and then decreased with the increasing of age,which reached its peak in the age group of 55 ～(10.20%);the incidence of males appeared two peaks in the age group of 25 ～(7.83%)and 55～(7.61%);the incidence of females also increased first and then decreased with the increasing of age,which reached its peak in the age group of and 65～(14.17%).The cumulative incidence of males was higher than that of females before the age of 45,while the cumulative incidence of females was higher than that of males after 45 years old.The cumulative incidence of NAFLD was highest in the obesity group of total,men and women,which were13.52%,10.66% and 20.66% respectively,and it was increased with the increasing of BMI.The cumulative incidence of NAFLD was increased with the rising of waist circumference and waist-to-height ratio.3.The prevalence of NAFLD in population who like high oil and salt diet,eating dry and eating pickled food frequently were very high,so these people were high risk group of NAFLD.People who were overweight,obesity and central obesity were also high risk group of NAFLD.Multivariable Logistic regression analysis showed that meat intake >0.35 kg/week,often eating pickled dry food,overweight,obesity and central obesity can increase the risk of NAFLD,and ORs(95%CI)were 1.11(1.01-1.23),1.52(1.29-1.79),2.29(2.05-2.55),4.51(3.88-5.26)and1.48(1.30-1.67),respectively.Roughage intak ≥0.5 kg/week can reduce the risk of NAFLD(OR=0.83,95%CI: 0.76-0.91).After gender stratification,in men,meat intake ≥0.35 kg/week,soy intake ≥0.25 kg/week,eating pickled dry food frequently,overweight,obesity and central obesity may increase the risk of NAFLD,and ORs(95%CI)were 1.16(1.01-1.32),1.15(1.02-1.29),1.44(1.18-1.77),2.18(1.90-2.51),4.81(3.96-5.85)and 1.35(1.15-1.59),respectively.Roughage intake ≥0.5 kg/week and often eating salad or fresh vegetables can reduce the risk of NAFLD,and ORs(95%CI)were 0.89(0.79-1.00)and 0.64(0.44-0.92),respectively.In women,eggs intake >1.75 kg/month,high sugar diet,often eating pickled dry food,overweight,obesity,central obesity diagnosed by WC and central obesity diagnosed by WHt R can increase the risk of NAFLD,and ORs(95%CI)were 1.21(1.04-1.42),1.35(1.10-1.67),1.42(1.08-1.88),2.63(2.19-3.17),4.39(3.41-5.64),1.71(1.41-2.06)and 1.37(1.14-1.65),respectively.Roughage intake ≥0.5 kg/week can reduce the risk of NAFLD(OR=0.74,95%CI: 0.63-0.87).4.Multiariable Cox regression analysis showed that overweight,obesity and central obesity increased the risk of NAFLD,and HRs(95%CI)were 2.18(1.82-2.61),2.87(2.26-3.65)and1.47(1.18-1.83),respectively.After gender stratification,in men,eating pickled dry food sometimes,overweight,obesity and central obesity increased the risk of NAFLD,and HRs(95%CI)were 1.50(1.08-2.08),2.75(2.08-3.64),4.43(2.98-6.57)and 1.72(1.23-2.41),respectively.In women,high salt diet,overweight,obesity and central obesity increased the risk of NAFLD,and HRs(95%CI)were 1.33(1.01-1.76),1.82(1.43-2.30),2.31(1.70-3.14)and 1.58(1.19-2.10)respectively.5.The AUC(95% CI)of BMI,WC and WHt R in men were 0.74(0.73 0.75),0.68(0.67 0.68),0.68(0.66 0.69),respectively,while were 0.78(0.76 0.79),0.72(0.71 0.74),0.72(0.71 0.73)in women.The AUC of BMI is greater than the other two indicators both in men and women.The best point of tangency for predicting NAFLD of BMI,WC and WHt R were 24.34 kg/m2,89.50 cm,89.50 in men and 23.80 kg/m2,79.50 cm,0.49 in women,respectively.Conclusions 1.The prevalence and incidence of NAFLD were quite high in Jinchang cohort,and it appeared the younger trend especially in the male population.2.The population who liked high oil or salt diet,eating dry food and pickled dry food frequently were at high risk of NAFLD.People who were overweight,obesity or central obesity were also high risk group.3.Eating more whole grain and salad or fresh vegetables could reduce the risk of NAFLD.Eating pickled dry food,more meat intake,overweight,obesity and central obesity were risk factors of NAFLD.4.Prospective cohort study confirmed that high salt diet,eating pickled dry food,overweight,obesity and central obesity were risk factors of NAFLD.5.The value for forecasting NAFLD of BMI was higher than that of WC and WHt R,and the optimal cut-off values of these indicators were close to boundary values of overweight and central obesity both in male and female. |
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