Depression in Non-Alcoholic Fatty Liver Disease is Associated with an increased Risk of Complications and Mortality (Frontiers in Medicine)

Background & Aims The global prevalence of non-alcoholic fatty liver disease (NAFLD) is expected to rise continuously. Furthermore, emerging evidence has also shown the potential for concomitant depression in NAFLD. This study aims to examine the prevalence, risk factors and adverse events of depression in NAFLD and evaluate whether treated depression can reverse the increased risks of adverse outcomes. Methods This study analyses the 2000-2018 cycles of NHANES that examined liver steatosis with fatty liver index. The relationship between NAFLD and depression was assessed with a generalized linear mix model and a sensitivity analysis was conducted in the no depression, treated depression and untreated depression groups. Survival analysis was conducted with cox regression and fine grey sub-distribution model. Results 21,414 patients were included and 6,726 were diagnosed with NAFLD. The risk of depression in NAFLD was 12% higher compared to non-NAFLD individuals (RR:1.12, CI:1.00-1.26, p=0.04). NAFLD individuals with depression were more likely to be older, females, Hispanics or Caucasians, diabetic and higher BMI. Individuals with depression have high risk for cardiovascular diseases (CVD) (RR:1.40, CI:1.25-1.58, p