Diabetes, obesity & metabolism · 2025
Obesity drives the link between liver fat and depression: Cross-sectional and prospective investigations.
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Feng Qi, Izzi-Engbeaya Chioma N, Manousou Pinelopi, Woodward Mark
Аннотация
AIMS: Inconsistent associations have been reported between steatotic liver disease (SLD) and depression. We aimed to investigate the cross-sectional and prospective associations between MRI-derived liver fat, SLD and depression.
MATERIALS AND METHODS: We used UK Biobank data. Liver fat was measured with liver MRI proton density fat fraction. SLD was defined as liver fat ≥5%. Depression was identified through self-reported diagnosis and hospital records. We examined cross-sectional associations using logistic regression and prospective associations using Cox proportional hazards models, adjusting for potential confounders, including socioeconomic status, lifestyle factors and body mass index (BMI).
RESULTS: Participants numbering 36 587 were included (age 64.5 years, 51.4% females, 28.2% SLD), and of these, 2849 participants had prevalent depression, higher in individuals with SLD (9.1%) than in those without (7.3%). SLD was associated with 40% higher odds of depression (OR: 1.40 (1.29, 1.52)) after adjusting for age, sex and socioeconomic status, but this was attenuated (OR: 1.12 (1.01, 1.23)) after adjusting for BMI. In the prospective analysis (n = 33 762), 414 people received a new diagnosis of depression over a median follow-up of 4.5 years. SLD was initially associated with a 27% higher depression risk (HR: 1.27 [1.03, 1.56]), but this was no longer significant after BMI adjustment (HR: 0.93 (0.73, 1.18)). Liver fat (per 5% increase) was not associated with depression risk (HR: 1.02 (0.92, 1.12)). No sex differences were identified.
CONCLUSIONS: The association between liver fat and depression is likely due to reverse causation and the confounding effect of BMI.
MATERIALS AND METHODS: We used UK Biobank data. Liver fat was measured with liver MRI proton density fat fraction. SLD was defined as liver fat ≥5%. Depression was identified through self-reported diagnosis and hospital records. We examined cross-sectional associations using logistic regression and prospective associations using Cox proportional hazards models, adjusting for potential confounders, including socioeconomic status, lifestyle factors and body mass index (BMI).
RESULTS: Participants numbering 36 587 were included (age 64.5 years, 51.4% females, 28.2% SLD), and of these, 2849 participants had prevalent depression, higher in individuals with SLD (9.1%) than in those without (7.3%). SLD was associated with 40% higher odds of depression (OR: 1.40 (1.29, 1.52)) after adjusting for age, sex and socioeconomic status, but this was attenuated (OR: 1.12 (1.01, 1.23)) after adjusting for BMI. In the prospective analysis (n = 33 762), 414 people received a new diagnosis of depression over a median follow-up of 4.5 years. SLD was initially associated with a 27% higher depression risk (HR: 1.27 [1.03, 1.56]), but this was no longer significant after BMI adjustment (HR: 0.93 (0.73, 1.18)). Liver fat (per 5% increase) was not associated with depression risk (HR: 1.02 (0.92, 1.12)). No sex differences were identified.
CONCLUSIONS: The association between liver fat and depression is likely due to reverse causation and the confounding effect of BMI.