Impact of cigarette smoking on onset of nonalcoholic fatty liver disease over a 10-year period
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Metabolic syndrome, which includes obesity, hyperglycemia, dyslipidemia, and hypertension, is a major risk factor for the development of nonalcoholic fatty liver disease (NAFLD). Cigarette smoking is a well-known risk factor for metabolic syndrome, but the epidemiological impact of cigarette smoking on development of NAFLD is unclear.
In this retrospective study, 2,029 subjects underwent a complete medical health checkup in 1998 and again in 2008. Those who were positive for hepatitis B surface antigen or hepatitis C virus antibody, or had an alcohol intake of >20 g/day as assessed by questionnaire, were excluded. Fatty liver was diagnosed by abdominal ultrasonography. Independent risk factors associated with the development of NAFLD were determined by multiple logistic regression analysis. Smoking status was expressed using the Brinkman index (BI), which was calculated as the number of cigarettes smoked per day multiplied by the number of years of smoking.
Of 1,560 subjects without NAFLD in 1998, 266 (17.1%) were newly diagnosed with NAFLD in 2008. Multiple logistic analysis identified age [adjusted odds ratio (AOR) 0.95, 95% confidence interval (95% CI) 0.94–0.97], male sex (AOR 1.46, 95% CI 1.01–2.10), body mass index ≥25 (AOR 3.08, 95% CI 2.20–4.32), dyslipidemia (AOR 1.79, 95% CI 1.25–2.58) and cigarette smoking (AOR 1.91, 95% CI 1.34–2.72) as risk factors associated with the development of NAFLD. Smoking status at baseline was also associated with the development of NAFLD (BI 1–399: AOR 1.77, 95% CI 1.02–3.07, BI ≥400: AOR 2.04, 95% CI 1.37–3.03).
Cigarette smoking is an independent risk factor for onset of NAFLD.
KeywordsNAFLD Risk factor Brinkman index Body mass index Metabolic syndrome
- 14.Fagard RH, Nilsson PM. Smoking and diabetes—the double health hazard! Prim Care Diabetes. 2009;3:205–9.Google Scholar
- 21.Japanese Society of Internal Medicine. Definition criteria of the metabolic syndrome for Japanese population. J Jpn Soc Int Med. 2005;94:188–203.Google Scholar
- 22.World Health Organization Western Pacific Region, International Association for the Study of Obesity/International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne: Health Communications Australia; 2000.Google Scholar
- 36.El-Zayadi AR, Selim O, Hamdy H, El-Tawil A, Moustafa H. Heavy cigarette smoking induces hypoxic polycythemia (erythrocytosis) and hyperuricemia in chronic hepatitis C patients with reversal of clinical symptoms and laboratory parameters with therapeutic phlebotomy. Am J Gastroenterol. 2002;97:1264–5.PubMedCrossRefGoogle Scholar
- 45.Economou F, Xyrafis X, Livadas S, Androulakis II, Argyrakopoulou G, Christakou CD, et al. In overweight/obese but not in normal-weight women, polycystic ovary syndrome is associated with elevated liver enzymes compared to controls. Hormones (Athens). 2009;8:199–206.Google Scholar
- 47.Oza N, Eguchi Y, Mizuta T, Ishibashi E, Kitajima Y, Horie H, et al. A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff. J Gastroenterol. 2009;44:1203–8.PubMedCrossRefGoogle Scholar
- 48.Hiramine Y, Imamura Y, Uto H, Koriyama C, Horiuchi M, Oketani M, et al. Alcohol drinking patterns and the risk of fatty liver in Japanese men. J Gastroenterol. doi:10.1007/s00535-010-0336-z.
- 49.Bailey SM, Mantena SK, Millender-Swain T, Cakir Y, Jhala NC, Chhieng D, et al. Ethanol and tobacco smoke increase hepatic steatosis and hypoxia in the hypercholesterolemic apoE(−/−) mouse: implications for a “multihit” hypothesis of fatty liver disease. Free Radic Biol Med. 2009;46:928–38.PubMedCrossRefGoogle Scholar