TY - JOUR
T1 - Physical Activity, Measured Objectively, Is Associated With Lower Mortality in Patients With Nonalcoholic Fatty Liver Disease
AU - Kim, Donghee
AU - Murag, Soumya
AU - Cholankeril, George
AU - Cheung, Amanda
AU - Harrison, Stephen A.
AU - Younossi, Zobair M.
AU - Ahmed, Aijaz
N1 - Funding Information:
Donghee Kim, MD, PhD (Conceptualization: Lead; Data curation: Lead; Formal analysis: Lead; Investigation: Lead; Methodology: Lead; Supervision: Lead; Writing – original draft: Lead);, Soumya Murag (Conceptualization: Equal; Investigation: Equal; Writing – review & editing: Equal);, George Cholankeril (Conceptualization: Equal; Investigation: Equal; Writing – review & editing: Equal);, Amanda Cheung (Conceptualization: Equal; Investigation: Equal; Writing – review & editing: Equal);, Stephen Harrison (Conceptualization: Equal; Investigation: Equal; Writing – review & editing: Equal);, Zobair Younossi (Conceptualization: Equal; Investigation: Equal; Writing – review & editing: Equal);, Aijaz Ahmed (Conceptualization: Lead; Investigation: Lead; Methodology: Lead; Supervision: Lead; Writing – original draft: Equal; Writing – review & editing: Lead).
Publisher Copyright:
© 2021 AGA Institute
PY - 2021/6
Y1 - 2021/6
N2 - Background & Aims: The association between physical activity (PA) and all-cause and cause-specific mortality from nonalcoholic fatty liver disease (NAFLD) requires investigation. We studied whether PA, measured by accelerometer, is associated with all-cause and cause-specific mortality among individuals with NAFLD. Methods: We performed a longitudinal analysis using the 2003 to 2006 US National Health and Nutrition Examination Survey data of adults (age, ≥20 y) and collecting mortality data through December 2015. NAFLD was defined based on the hepatic steatosis index or US fatty liver index scores, in the absence of other causes of chronic liver disease. PA was measured from participants who wore accelerometers 10 h/d for a minimum of 4 days over a 7-day period and were classified as total PA, moderate to vigorous PA (MVPA), and sedentary behavior. Results: Over an average follow-up period of 10.6 years, increasing the duration of total PA was associated with a reduced risk of death, from any cause, in an age- and sex-adjusted model (hazard ratio [HR], 0.52; 95% CI, 0.32–0.86 for highest quartile vs lowest quartile; P for trend =.001) and multivariable model (HR, 0.46; 95% CI, 0.28–0.75; P for trend <.001) among individuals with NAFLD. Increasing the duration of MVPA was associated with a lower risk of death from any cause in individuals with NAFLD. Furthermore, longer total PA was associated with a lower risk for cardiovascular disease–related death in individuals with NAFLD (HR, 0.28; 95% CI, 0.08–0.98 for highest quartile vs lowest quartile; P for trend =.007). We did not find this association for cancer-related mortality in individuals with NAFLD. Increasing the duration of sedentary behavior did not affect all-cause or cause-specific mortality in individuals with NAFLD. Conclusions: Longer total PA and MVPA, measured by accelerometers over a 7-day period, are associated with lower all-cause and cardiovascular mortality in individuals with NAFLD.
AB - Background & Aims: The association between physical activity (PA) and all-cause and cause-specific mortality from nonalcoholic fatty liver disease (NAFLD) requires investigation. We studied whether PA, measured by accelerometer, is associated with all-cause and cause-specific mortality among individuals with NAFLD. Methods: We performed a longitudinal analysis using the 2003 to 2006 US National Health and Nutrition Examination Survey data of adults (age, ≥20 y) and collecting mortality data through December 2015. NAFLD was defined based on the hepatic steatosis index or US fatty liver index scores, in the absence of other causes of chronic liver disease. PA was measured from participants who wore accelerometers 10 h/d for a minimum of 4 days over a 7-day period and were classified as total PA, moderate to vigorous PA (MVPA), and sedentary behavior. Results: Over an average follow-up period of 10.6 years, increasing the duration of total PA was associated with a reduced risk of death, from any cause, in an age- and sex-adjusted model (hazard ratio [HR], 0.52; 95% CI, 0.32–0.86 for highest quartile vs lowest quartile; P for trend =.001) and multivariable model (HR, 0.46; 95% CI, 0.28–0.75; P for trend <.001) among individuals with NAFLD. Increasing the duration of MVPA was associated with a lower risk of death from any cause in individuals with NAFLD. Furthermore, longer total PA was associated with a lower risk for cardiovascular disease–related death in individuals with NAFLD (HR, 0.28; 95% CI, 0.08–0.98 for highest quartile vs lowest quartile; P for trend =.007). We did not find this association for cancer-related mortality in individuals with NAFLD. Increasing the duration of sedentary behavior did not affect all-cause or cause-specific mortality in individuals with NAFLD. Conclusions: Longer total PA and MVPA, measured by accelerometers over a 7-day period, are associated with lower all-cause and cardiovascular mortality in individuals with NAFLD.
KW - Death
KW - Exercise
KW - Lifestyle Modification
KW - Movement
UR - http://www.scopus.com/inward/record.url?scp=85103706719&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103706719&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2020.07.023
DO - 10.1016/j.cgh.2020.07.023
M3 - Article
C2 - 32683103
AN - SCOPUS:85103706719
SN - 1542-3565
VL - 19
SP - 1240-1247.e5
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 6
ER -
