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Fatty liver disease correlates with smaller brain volume in middle-aged adults
Patients with nonalcoholic fatty liver disease had significantly smaller total cerebral brain volume, independent of visceral adipose tissue and cardiometabolic risk factors, according to a recently published study.
“NAFLD can be improved by lifestyle modifications such as dietary restriction and increased physical activity,” Galit Weinstein, PhD, from the University of Haifa, Israel, told Healio.com/Hepatology. “If one retains a healthy liver, his/her risk for diseases such as diabetes and cardiovascular diseases is also reduced. In this study, we show that keeping a healthy liver may also be linked with a healthier brain.”
From Nov. 16, 2002, to Apr. 29, 2005, the researchers enrolled 766 participants who underwent multidetector computer tomography and magnetic resonance imaging. Mean participant age was 67 years, 410 were women and 137 had NAFLD.
Compared with participants without NAFLD, those with NAFLD were more likely to be men (56.9% vs. 44.2%; P = .007) and have type 2 diabetes (13.9% vs. 6.2%; P = .002), higher BMI (5.5% vs. 4.7%; P < .001), hypertension (47.4% vs. 32.4%; P = .001), increased mean visceral adipose tissue (1,009 cm vs. 983 cm; P < .001) and higher median alanine aminotransferase levels (22 U/L vs. 18 U/L; P < .001).
Additionally, participants with NAFLD had smaller mean total cerebral brain volume (78.3% vs. 79.4%; P = .002). The mean time between abdominal CT scan and brain MRI examinations was slightly longer for participants with NAFLD compared with those without NAFLD (3.2 vs. 3 years; P = .03).
After the researchers adjusted for age, sex, alcohol consumption and time between CT and MRI measurements, they found NAFLD correlated with smaller total brain volume (beta = –0.34; P < .001).
The association between NAFLD and smaller total brain volume remained significant after further adjustment for visceral adipose tissue, BMI, menopausal status, blood pressure, hypertension, levels of high-density lipoprotein, current smoking, diabetes, history of cardiovascular disease and physical activity index (beta = –0.26; P = .02).
Among participants aged younger than 60 years, the difference in total brain volume between those with and without NAFLD corresponded to 7.3 years of brain aging. The estimated number of years of brain aging was lower among older participants: 4.2 years of brain aging for those aged 60 years to 74 years, and 1.5 years for participants aged 75 years or older.
“We found that the brain of individuals with fatty liver is older compared to those with a healthy liver. This finding still holds after we consider the differences in life-style, health status and amount of abdominal fat between the participants. This means, that liver fat may have a direct association with brain aging,” Weinstein told Healio.com/Hepatology. “This point is extremely important, because currently there is usually no cure for neurodegenerative diseases such as Alzheimer’s disease. But it still remains to show in future studies, that improvement in fatty liver disease is associated with lower risk of such brain diseases. ” – by Talitha Bennett
Disclosure: The authors report no relevant financial disclosures.