Risk Factors for Non-alcoholic Fatty Liver Disease in Chinese Population: A Five-year Follow-up Study

Background: Non-alcoholic Fatty Liver Disease (NAFLD) has become the first liver disease worldwide. Objectives: This study aimed to explore the prospective risk factors for NAFLD in a large sample of the Chinese population in a five-year follow-up. Methods: In a cohort study, 1,277 subjects, enrolled in the Second Hospital of Dalian Medical University, were screened initially in 2013 and followed up yearly until 2017. NAFLD was diagnosed based on the ultrasound criteria and the absence of excessive alcohol intake. The follow-up parameters, obtained for 1,165 subjects, included both clinical parameters (body mass index and blood pressure) and biological parameters (fasting plasma glucose (FPG), plasma lipid indices, liver function parameters, and hematological parameters). All statistical analyses were performed using SPSS v20.0 software, and the logistic regression analysis was used to evaluate the risks for incidental and sustained NAFLD. Results: Individuals with NAFLD at the baseline were more frequently male, old, obese, hypertensive, and diabetic, with hyperuricemia, dyslipidemia, higher liver enzymes, and higher hematological parameters (all P < 0.001). Logistic regression analysis showed that BMI and dyslipidemia were the independent predictors of NAFLD (OR = 1.2, 0.1, 5.2, 10.6, and 16.7 for BMI, TC, TG, LDL-C, and HDL-C, respectively, all P < 0.05). Moreover, increased systolic and diastolic blood pressure, and the serum transaminases (OR of 0.97, 1.04, and 1.02) were independently associated with sustained NAFLD (all P < 0.001). Conclusions: The present study indicated that increased BMI and dyslipidemia are the potential predictors of NAFLD development and that hypertension and hypertransaminasemia could be the risk factors for NAFLD maintenance. These findings may have practical therapeutic implications.