Healthy Lifestyle Is Associated with Reduced Mortality in Patients with Non-Alcoholic Fatty Liver Disease
Chengxiao Yu,
Jiaxin Gao,
Xinyuan Ge,
Xiao Wang,
Yuqing Ding,
Ting Tian,
Xin Xu,
Wen Guo,
Quanrongzi Wang,
Zijun Ge,
Tao Jiang,
Qun Zhang,
Ci Song
Affiliations
Chengxiao Yu
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Jiaxin Gao
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Xinyuan Ge
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Xiao Wang
Department of Infectious Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yuqing Ding
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Ting Tian
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Xin Xu
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Wen Guo
Health Management Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Quanrongzi Wang
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zijun Ge
Office of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Tao Jiang
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Qun Zhang
Health Management Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Ci Song
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
Background and Aims: It is unclear whether a healthy lifestyle impacts mortality in the presence of non-alcoholic fatty liver disease (NAFLD). The present study aimed to examine the joint association of several modifiable lifestyle factors with mortality risk for NAFLD patients. Methods: We collected lifestyle behavior data form the National Health and Nutrition Examination Survey (NHANES) III from 1988 to 1994 and follow-up data form NHANES III-linked mortality data through 2015. We estimated joint association between four healthy lifestyle factors (non-smoking, non-drinking, regular physical activity, a healthy diet) after NAFLD diagnosis and mortality using Cox proportional hazards regression models. Results: During a median of 22.83 years of follow-up, 2932 deaths occurred. The risk of all-cause mortality decreased significantly with the healthy lifestyle scores increasing (p < 0.001). NAFLD patients with a favorable lifestyle (3 or 4 healthy lifestyle factors) reduced 36% of all-cause mortality and 43% of cardiovascular disease (CVD) mortality compared with those with an unfavorable lifestyle (0 or 1 healthy lifestyle factor) (HR, 0.64 [95% CI, 0.50–0.81], 0.57 [95% CI, 0.37–0.88]). Compared with the non-NAFLD group, the number of NAFLD patients required to adhere to a favorable lifestyle to prevent one cardiovascular disease death in 20 years was fewer (77 vs. 125). Conclusions: For the NAFLD patients, adopting a healthy lifestyle could significantly reduce their risk of death.