Abstract P341: Nonalcoholic Fatty Liver Disease (NAFLD) and Risk of Incident Cognitive Impairment
Background: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent form of liver disease in the United States and is often considered the hepatic manifestation of the metabolic syndrome. Despite other types of liver disease being associated with cognitive dysfunction, little is known about the impact of NAFLD on cognition.
Hypothesis: NAFLD is associated with incident cognitive impairment in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
Methods: REGARDS recruited 30,239 black and white U.S. men and women to study regional and racial differences in stroke mortality. Among participants with normal baseline cognitive function, we identified 495 cases of incident cognitive impairment over 3.4 years, using 3 cognitive domain tests: list learning, list recall, and verbal fluency. Thresholds for impaired function were defined adjusting for age, race, sex, and education level. The Fatty Liver Index (FLI), a validated surrogate marker for NAFLD, was determined in cases and 587 controls, with FLI >60 considered a positive score. Excluding 36 participants with heavy alcohol consumption, logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of cognitive impairment for NAFLD and its components. The contribution of diabetes to this risk was estimated with bootstrapping.
Results: NAFLD was associated with increased odds of cognitive impairment in both models (table). Of the components of FLI, only waist circumference was associated in the fully adjusted model (see table). Diabetes explained 28% of the increased odds for cognitive impairment with NAFLD by (95% CI: 7%, 58%). There were no differences in associations of NAFLD with cognitive impairment by race, sex, age or diabetes status (interaction p values all >0.10).
Discussion: NAFLD, as determined by FLI, was associated with increased risk of incident cognitive impairment, independent of other risk factors. Further research is needed to understand the mechanisms behind this association.
Author Disclosures: K.S. Alexander: None. N.A. Zakai: None. S.R. Gillett: None. S.D. Lidofsky: None. P.W. Callas: None. F. Unverzagt: None. V. Wadley: None. S.E. Judd: None. M. Cushman: None.
- © 2015 by American Heart Association, Inc.