Non-alcoholic fatty liver disease and associated risk factors in health care professionals in a community hospital in Brazil

Abstract

Introduction: Health care professionals are vulnerable to several health problems, including overweight, stress and anxiety. As such, non-alcoholic fatty liver disease is a likely diagnosis in this population. Objectives: To investigate the association between non-alcoholic fatty liver disease and levels of stress and anxiety in a sample of health care workers in a community hospital in the state of Rio Grande do Sul. Methods: The sample consisted of 107 health care workers who were interviewed and screened for non-alcoholic fatty liver disease based on clinical, imaging and laboratory parameters. Occupational stress was evaluated using Lipp’s Stress Symptom Inventory, and anxiety was assessed using the Hamilton Anxiety Rating Scale. Results: The mean age of the sample was 37.6 years. Most participants were female (89.1%) and the most frequent occupation was nursing technicians (83.2%). While 77.22% of participants did not report significant levels of stress, 30.7% did have mild anxiety. Statistical tests did not reveal a significant association between non-alcoholic fatty liver disease and stress (p = 0.688) or anxiety (p = 0.996). Conclusions: All participants with non-alcoholic fatty liver disease had some degree of anxiety, but only some experienced stress symptoms, according to Lipp’s Inventory. Statistical tests did not confirm an association between stress, anxiety and the presence non-alcoholic fatty liver disease. Nevertheless, the potential association between these variables should continue to be investigated given the global rise in the prevalence of non-alcoholic fatty liver disease and its implications for health care workers.

Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults: a systematic review and meta-analysis

“…For the 31 studies included in this systematic review, NAFLD was defined by various means including liver biopsy, ultrasonography/evidence of ultrasound, hepatic steatosis index, pathology and/or radiologic testing, computed tomography, magnetic resonance imaging, and self-reported physician diagnosis ( Table 1 ). From the 31 included studies, 18 studies (58%) measured only depression ( 44 , 49 – 53 , 57 , 58 , 61 – 70 ), one study measured only anxiety ( 55 ), 10 studies (32%) measured depression and anxiety ( 43 , 45 – 48 , 56 , 60 , 71 – 73 ), one study measured only stress ( 54 ), and one study measured stress and anxiety ( 59 ). In these studies, the mental health conditions of interest were identified by validated measures (including DSM-IV and ICD-10) in 17 studies ( 44 , 46 , 48 , 49 , 53 , 54 , 56 – 59 , 63 , 65 – 68 , 70 , 73 ), self-reported in six studies ( 43 , 47 , 55 , 61 , 62 , 69 ), or identified by other diagnosis (e.g., medical history) in eight studies ( 45 , 50 – 52 , 60 , 64 , 71 , 72 ).…”

“…From the 31 included studies, 18 studies (58%) measured only depression ( 44 , 49 – 53 , 57 , 58 , 61 – 70 ), one study measured only anxiety ( 55 ), 10 studies (32%) measured depression and anxiety ( 43 , 45 – 48 , 56 , 60 , 71 – 73 ), one study measured only stress ( 54 ), and one study measured stress and anxiety ( 59 ). In these studies, the mental health conditions of interest were identified by validated measures (including DSM-IV and ICD-10) in 17 studies ( 44 , 46 , 48 , 49 , 53 , 54 , 56 – 59 , 63 , 65 – 68 , 70 , 73 ), self-reported in six studies ( 43 , 47 , 55 , 61 , 62 , 69 ), or identified by other diagnosis (e.g., medical history) in eight studies ( 45 , 50 – 52 , 60 , 64 , 71 , 72 ). Characteristics of the included studies are presented in Table 1 .…”

“…In total, 28 of the included studies measured depression, with the total number of participants amounting to 2,079,270. Validated instruments were used to measure depression in 15 studies ( 44 , 46 , 49 , 53 , 56 – 59 , 63 , 65 – 68 , 70 , 73 ), while self-report and other diagnosis (e.g., medical history) were used in five ( 43 , 47 , 61 , 62 , 69 ) and eight studies ( 45 , 50 – 52 , 60 , 64 , 71 , 72 ), respectively. Of these studies, 11 were from the USA ( 47 , 48 , 51 , 58 , 60 , 63 , 69 – 73 ), resulting in a total of 1,989,154 participants from this geographical region.…”

“…Of the studies reporting depression, ten additionally measured anxiety, resulting in a total of 12 studies measuring anxiety ( 43 , 45 – 48 , 55 , 56 , 59 , 60 , 71 – 73 ), with the corresponding total number of participants amounting to 35,034. Validated instruments were used to measure anxiety in four studies ( Table 1 ), utilizing the DSM-IV ( 48 ), ICD-10 ( 56 ), the Hamilton Anxiety Rating Scale ( 59 ) and the Hospital Anxiety and Depression Scale ( 73 ). Self-report and other diagnosis (e.g., medical history) were used in three ( 43 , 47 , 55 ) and four studies ( 45 , 60 , 71 , 72 ), respectively.…”

“…One of the included studies also measured stress in addition to anxiety ( 59 ). In total, only two of the included studies investigated stress in association with NAFLD ( 54 , 59 ), involving a total of 47,564 participants. However, one of these studies ( 54 ), conducted in South Korea, included 47,538 participants.…”