Associations of depression score with metabolic dysfunction-associated fatty liver disease and liver fibrosis

• Published in: Journal of affective disorders Vol. 334; pp. 332 - 336
• Main Authors: Cai, Hongwei, Zhang, Rui, Zhao, Chuanhao, Wang, Yuzhuo, Tu, Xiaoming, Duan, Weiwei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2023
• Subjects: Adult; Cross-Sectional Studies; Depression - epidemiology; Depressive Disorder, Major; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - epidemiology; Liver fibrosis; Metabolic dysfunction-associated fatty liver disease; Mild depression; NHANES; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnostic imaging; Non-alcoholic Fatty Liver Disease - epidemiology; Nonalcoholic fatty liver disease; Nutrition Surveys; PHQ-9; Psychiatric/Mental Health; Nonalcoholic fatty liver disease; NHANES; Liver fibrosis; Mild depression; PHQ-9; Metabolic dysfunction-associated fatty liver disease
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2023.04.093

Growing evidence suggests a link between depression and nonalcoholic fatty liver disease (NAFLD). Recently, a change from NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed. The aim of this study was to determine whether depression scores are associated with newly defined MAFLD as well as liver fibrosis in the US general population. This cross-sectional study utilized data from the 2017–March 2020 cycle of the National Health and Nutrition Examination Survey (NHANES) in the US. The depression score was assessed with the Patient Health Questionnaire-9 (PHQ-9). Transient elastography was utilized to evaluate hepatic steatosis and fibrosis with controlled attenuation parameters and liver stiffness measurements, respectively. All the analyses accounted for the complex design parameters and sampling weights of the survey. A total of 3263 eligible subjects aged 20 years and older were included. The estimated prevalence of mild and major depression was 17.0 % (95 % confidence interval [CI]: 14.8–19.3 %) and 7.1 % (6.1–8.1 %), respectively. For every one-unit increase in depression score, a subject was 1.05 (1.02–1.08) times more likely to have MAFLD. Compared to the minimal depression group, those with mild depression had an odds ratio (OR) of 1.54 (1.06–2.25) for MAFLD. The depression score was not associated with clinically significant liver fibrosis. The depression score measured by PHQ-9 was independently associated with MAFLD among US adults. Causal relationship is not available due to the cross-sectional nature of the survey design. •A large nationally representative sample of the US general population were included.•Transient elastography was utilized to evaluate hepatic steatosis and fibrosis.•The nationwide prevalence of major depression was 7.1 % (95%CI, 6.1–8.1 %).•Mild depression was an independent risk factor of newly defined MAFLD.•The depression score was not associated with clinically significant liver fibrosis.