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Open AccessArticle

Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity

1
Minerva Foundation Institute for Medical Research, 00290 Helsinki, Finland
2
Department of Medicine, University of Helsinki, Helsinki University Hospital, 00290 Helsinki, Finland
3
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8056, USA
4
Abdominal Center, Department of Gastrointestinal Surgery, Helsinki University Hospital, 00290 Helsinki, Finland
5
Department of Pathology, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland
6
Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, 20502 Malmö, Sweden
*
Author to whom correspondence should be addressed.
Nutrients 2021, 13(1), 169; https://doi.org/10.3390/nu13010169
Received: 14 December 2020 / Revised: 4 January 2021 / Accepted: 5 January 2021 / Published: 8 January 2021
(This article belongs to the Section Nutrition and Metabolism)
Only some individuals with obesity develop liver fibrosis due to non-alcoholic fatty liver disease (NAFLD-fibrosis). We determined whether detailed assessment of lifestyle factors in addition to physical, biochemical and genetic factors helps in identification of these patients. A total of 100 patients with obesity (mean BMI 40.0 ± 0.6 kg/m2) referred for bariatric surgery at the Helsinki University Hospital underwent a liver biopsy to evaluate liver histology. Physical activity was determined by accelerometer recordings and by the Modifiable Activity Questionnaire, diet by the FINRISK Food Frequency Questionnaire, and other lifestyle factors, such as sleep patterns and smoking, by face-to-face interviews. Physical and biochemical parameters and genetic risk score (GRS based on variants in PNPLA3, TM6SF2, MBOAT7 and HSD17B13) were measured. Of all participants 49% had NAFLD-fibrosis. Independent predictors of NAFLD-fibrosis were low moderate-to-vigorous physical activity, high red meat intake, low carbohydrate intake, smoking, HbA1c, triglycerides and GRS. A model including these factors (areas under the receiver operating characteristics curve (AUROC) 0.90 (95% CI 0.84–0.96)) identified NAFLD-fibrosis significantly more accurately than a model including all but lifestyle factors (AUROC 0.82 (95% CI 0.73–0.91)) or models including lifestyle, physical and biochemical, or genetic factors alone. Assessment of lifestyle parameters in addition to physical, biochemical and genetic factors helps to identify obese patients with NAFLD-fibrosis. View Full-Text
Keywords: physical activity; diet; stress; glucose; insulin physical activity; diet; stress; glucose; insulin
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MDPI and ACS Style

Lahelma, M.; Luukkonen, P.K.; Qadri, S.; Ahlholm, N.; Lallukka-Brück, S.; Porthan, K.; Juuti, A.; Sammalkorpi, H.; Penttilä, A.K.; Arola, J.; Orho-Melander, M.; Yki-Järvinen, H. Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity. Nutrients 2021, 13, 169. https://doi.org/10.3390/nu13010169

AMA Style

Lahelma M, Luukkonen PK, Qadri S, Ahlholm N, Lallukka-Brück S, Porthan K, Juuti A, Sammalkorpi H, Penttilä AK, Arola J, Orho-Melander M, Yki-Järvinen H. Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity. Nutrients. 2021; 13(1):169. https://doi.org/10.3390/nu13010169

Chicago/Turabian Style

Lahelma, Mari; Luukkonen, Panu K.; Qadri, Sami; Ahlholm, Noora; Lallukka-Brück, Susanna; Porthan, Kimmo; Juuti, Anne; Sammalkorpi, Henna; Penttilä, Anne K.; Arola, Johanna; Orho-Melander, Marju; Yki-Järvinen, Hannele. 2021. "Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity" Nutrients 13, no. 1: 169. https://doi.org/10.3390/nu13010169

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