title: Association Between Pulmonary Function and Nonalcoholic Fatty Liver Disease in the NHANES III Study.
abstract: Emerging evidence indicates that nonalcoholic fatty liver disease (NAFLD) is associated with a wide variety of extrahepatic complications. However, the potential association between impaired pulmonary function and NAFLD has been less investigated. This study examined the relationship between pulmonary function and hepatic steatosis in 9976 adults participating in a cross-sectional analysis of the Third National Health and Nutrition Examination Survey (NHANES III). NAFLD was defined as hepatic steatosis presented on ultrasound examinations in the absence of other known liver diseases. The associations between predicted forced expiratory volume in 1 second (FEV1)% or predicted forced vital capacity (FVC)% and NAFLD were examined using multivariable linear regression while controlling for confounders. The association between obstructive or restrictive spirometry patterns and NAFLD was also evaluated using multivariable logistic regression analysis. After adjustment for multiple covariates, predicted FEV1% and FVC% were significantly and inversely associated with the degree of hepatic steatosis (P for trend <0.001 for both). The restrictive lung pattern was significantly related to participants with moderate and severe hepatic steatosis as compared with those without steatosis (OR 1.65, 95% CI 1.14-2.39 and OR 1.85, 95% CI 1.13-2.82), whereas the obstructive lung pattern was not associated with the presence of hepatic steatosis. Individuals with a greater degree of hepatic steatosis were at greater risk for poor pulmonary function, especially in restrictive pattern. These novel findings demonstrate that impaired pulmonary function is also an extrahepatic complication of NAFLD.
authors.affiliation: From the Division of Family Medicine (T-CP, T-WK, L-WW, Y-WC, C-CW, W-LC); Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei (T-WK, L-WW, Y-WC, W-LC); Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei (Y-JC, W-LC); and Department of Medicine, Taoyuan General Hospital, Taoyuan City, Taoyuan County, Taiwan (Y-TT).
authors.forename: Tao-Chun
authors.initials: TC
authors.lastname: Peng
authors.forename: Tung-Wei
authors.initials: TW
authors.lastname: Kao
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Wu
authors.forename: Ying-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Yaw-Wen
authors.initials: YW
authors.lastname: Chang
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Wang
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Tsao
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008173:Lung Diseases, Obstructive / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D009749:Nutrition Surveys; D044469:Racial Groups; D012129:Respiratory Function Tests; D055815:Young Adult