title: Association of a lifestyle index with MRI-determined liver fat content in a general population study.
abstract: BACKGROUND
  In prior studies, lifestyle indices were associated with numerous disease end points, but the association with fatty liver disease (FLD), a key correlate of cardiometabolic risk, is unknown. The aim was to investigate associations between a lifestyle index with liver fat content.
  
  
  METHODS
  Liver fat was quantified by MRI as liver signal intensity (LSI) in 354 individuals selected from a population-based cohort from Germany. Exposure to favourable lifestyle factors was quantified using an additive score with each factor modelled as a dichotomous trait. Favourable lifestyle factors were defined as waist circumference below 102 (men) or 88 cm (women), physical activity ≥3.5 h/week, never-smoking and a favourable dietary pattern, which was derived to explain liver fat variation. In a cross-sectional study, multivariable adjusted linear and logistic regression was applied to investigate the association between the lifestyle index (range 0-4, exposure) and LSI (modelled as a continuous trait or dichotomised as a FLD indicator variable, respectively).
  
  
  RESULTS
  Individuals with four favourable lifestyle factors (n=9%) had lower LSI values (ß -0.40; 95% CI -0.61 to -0.19) and a lower OR (0.09; 95% CI 0.03 to 0.30) for FLD compared with individuals with zero favourable lifestyle factors (n=10%).
  
  
  CONCLUSIONS
  A healthy lifestyle pattern was associated with less liver fat. Prospective studies are warranted.
authors.affiliation: Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany.
authors.forename: Manja
authors.initials: M
authors.lastname: Koch
authors.affiliation: Department of Radiology, University of Cologne, Cologne, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Borggrefe
authors.affiliation: Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Schlesinger
authors.affiliation: Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
authors.forename: Janett
authors.initials: J
authors.lastname: Barbaresko
authors.affiliation: Clinic for Diagnostic Radiology, University Medical Center Schleswig-Holstein, Kiel, Germany.
authors.forename: Godo
authors.initials: G
authors.lastname: Groth
authors.affiliation: PopGen Biobank, University Medical Center Schleswig-Holstein, Kiel, Germany.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Jacobs
authors.affiliation: Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.affiliation: Institute of Internal Medicine I, Christian-Albrechts University Kiel, Kiel, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Laudes
authors.affiliation: Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany.
authors.forename: Manfred J
authors.initials: MJ
authors.lastname: Müller
authors.affiliation: Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Bosy-Westphal
authors.affiliation: Clinic for Diagnostic Radiology, University Medical Center Schleswig-Holstein, Kiel, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Heller
authors.affiliation: Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D050218:Body Fat Distribution; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D015930:Diet Records; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005858:Germany; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008099:Liver / Q000737:chemistry*; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D055105:Waist Circumference
keywords: Epidemiology of chronic non communicable diseases; LIFESTYLE; NUTRITION; OBESITY; PHYSICAL ACTIVITY