Nonalcoholic fatty liver disease and measures of early brain health in middle-aged adults: The CARDIA study.
To assess associations between nonalcoholic fatty liver disease (NAFLD) and measures of brain health in a population-based sample of adults.



Participants from the CARDIA study (Y25 exam; age 43-55 years) with concurrent computed tomography quantification of liver fat, visceral adipose tissue (VAT), and brain magnetic resonance (MR) images were included (n = 505). NAFLD was identified after exclusion of other causes of liver fat. Total tissue volume (TTV) and gray matter cerebral blood flow (GM-CBF) were estimated using 3T brain MR images.



NAFLD prevalence was 18%. NAFLD was associated with lower TTV and GM-CBF after adjusting for intracranial volume, demographics, and health behaviors (P < 0.04 for all). In models with additional adjustment for cardiovascular risk factors, the association of NAFLD with GM-CBF remained significant (P = 0.04) but was attenuated after adjustment for VAT (P = 0.06) and eliminated with BMI (P = 0.20). NAFLD was not associated with TTV after adjustment for cardiovascular risk factors (P = 0.10) or additional adjustment for VAT (P = 0.14) or BMI (P = 0.05).



NAFLD is negatively associated with early brain health as assessed by MR measures of structure (TTV) and perfusion (GM-CBF). BMI and VAT attenuated this relationship, providing insight into the potential metabolic role of liver fat in brain health and disease.
Departments of Medicine-Gastroenterology & Hepatology and Preventive Medicine, Northwestern University, Chicago, Illinois, USA.
Lisa B
0000-0002-6264-2573
LB
VanWagner
Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
James G
JG
Terry
Division of Diabetes, Endocrinology & Metabolism, University of Minnesota, Minneapolis, Minnesota, USA.
Lisa S
LS
Chow
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA.
Amy C
0000-0003-3609-2595
AC
Alman
Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA.
Hakmook
H
Kang
Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, Georgia, USA.
Katherine H
KH
Ingram
Center for Health Metrics and Evaluation, American Heart Association, Dallas, Texas, USA.
Christina
C
Shay
Division of Preventive Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA.
Cora E
CE
Lewis
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
R Nick
RN
Bryan
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland, USA.
Lenore J
LJ
Launer
Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
J
J
Jeffrey Carr
D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D015438:Health Behavior; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D009929:Organ Size; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods