title: Rural Residency has a Protective Effect and Marriage is a Risk Factor for NAFLD.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is considered the leading cause of liver disease worldwide. Although many previous studies have evaluated the potential risk factors of NAFLD, few studies have determined the effect of residency or marriage status on NAFLD.
  
  
  OBJECTIVE
  We aim to evaluate whether residency and marriage status increased the risk factors for NAFLD.
  
  
  METHODS
  We utilized data from 5,052 participants, 18 years and older, from a cohort study conducted using 6,140 participants in northern Iran. The population was divided into 16 subgroups according to sex and age; the age groups had an interval of 10 years. We randomly selected the subjects from each subgroup in proportion to the size of each subpopulation group. Logistic regression analyses were conducted on NAFLD as an outcome of marriage status, residency (rural vs. urban), and other potential risk factors.
  
  
  RESULTS
  We found that NAFLD had an inverse association with rural living in men (OR = 0.513, 0.422 - 0.622, P value < 0.001) and women (OR = 0.431, 0.345 - 0.539, P value < 0.001). Furthermore, we determined that NAFLD had a direct association with marriage status for men (OR = 2.770, 2.004 - 3.831, P value < 0.001) and women (OR = 1.241, 1.033 - 1.490, P value = 0.0209).
  
  
  CONCLUSIONS
  While rural living has a protective effect on NAFLD, marriage may be a potential risk factor for this condition.
authors.affiliation: Gastrointestinal and Liver Disease Research Centre, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Motamed
authors.affiliation: Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Mansooreh
authors.initials: M
authors.lastname: Maadi
authors.affiliation: Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Masoudreza
authors.initials: M
authors.lastname: Sohrabi
authors.affiliation: Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
authors.affiliation: Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
authors.affiliation: Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Zamani
keywords: Marriage; NAFLD; Rural Living