Non-alcoholic fatty liver disease and socioeconomic determinants in an Iranian cohort study

Abstract

Background Non-alcoholic fatty liver disease (NAFLD) is widespread worldwide. On the other hand, social inequality and socioeconomic status (SES) can affect all aspects of health. Therefore, this study aimed to investigate the relationship between SES indicators and NAFLD. Methods This was a cross-sectional study using data from the registration phase of the Hoveyzeh Cohort Study, which included 10,009 individuals aged 35–70 years from May 2016 to August 2018. Fatty liver disease was determined based on Fatty Liver Index (FLI). The crude and adjusted odds ratios were calculated by logistic regression analysis to estimate associations between the fatty liver index and SES after controlling the potential confounders. Results According to the FLI index, there were 2,006 people with fatty liver (28%) and 5,246 people without fatty liver (72%). Several 4496 people (62%) were women. The chi-square test showed significant relationships between the educational level and skill level (P < 0.001), the wealth index (P < 0.001), and Townsend Index (P < 0.001) with fatty liver index. In multivariable analysis, after adjustment for age, sex, physical activity, smoking, type of residence, calorie intake, dyslipidemia, skill level, and diabetes, the wealth index (p < 0.001) was positively associated with the fatty liver index. Besides, a reverse and significant association was seen between the Townsend index and the fatty liver index(p < 0.001). In contrast, no significant associations were seen between gender and educational level with the fatty liver index. Conclusions A more vulnerable SES is associated with NAFLD. Fatty liver index and socioeconomic indicators can be powerful monitoring tools to monitor health differences in diagnosing NAFLD.

Barriers to Exercise in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Patient Survey

“…Koutny et al [ 38 ] found a significantly higher prevalence of NAFLD based on the fatty liver index (FLI) and liver FIB-4 scores in the low education group than in the high education group. However, a recent study found that people who were categorized in the highest wealth group were significantly more likely to have high FLI scores compared to those in the low wealth category [ 39 ]. The authors speculated that this could be a result of low physical activity and high calorie intake among these individuals.…”

Navigating the Link Between Non-alcoholic Fatty Liver Disease/Non-alcoholic Steatohepatitis and Cardiometabolic Syndrome

“…26 Recently, a significant correlation was established between skill level (skill level 1 covers the most basic positions; skill level 2 requires the effective comprehension of information like safety protocols and basic arithmetic; skill level 3 demands advanced abilities and specialised knowledge; skill level 4 entails solving intricate problems and making decisions grounded in extensive theoretical and experimental expertise within a specific area) and fatty liver index within a large middle-aged population, although no significant association was observed between sex and the presence of fatty liver. 27 Recently, an international group of experts suggested that NAFLD be redefined as metabolic dysfunction-associated steatotic liver disease (MASLD). 28 The potential effect of this change in nomenclature on the prediction of CVD risk remains uncertain.…”