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. 2019 Sep;39(9):1713-1721.
doi: 10.1111/liv.14161. Epub 2019 Jun 26.

Non-alcoholic fatty liver disease, liver fibrosis score and cognitive function in middle-aged adults: The Framingham Study

Galit Weinstein  1 , Kendra Davis-Plourde  2   3 , Jayandra J Himali  2   3   4 , Shira Zelber-Sagi  1   5 , Alexa S Beiser  2   3   4 , Sudha Seshadri  3   4   6
Affiliations

Non-alcoholic fatty liver disease, liver fibrosis score and cognitive function in middle-aged adults: The Framingham Study

Galit Weinstein et al. Liver Int. 2019 Sep.

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is common and has been recently related to brain health. We aimed to assess the relationships of NAFLD and its severity, using the NAFLD fibrosis score (NFS), with cognitive performance.

Methods: Framingham study Offspring and 3rd generation participants were included if they attended exams 9 (2002-2008) and 2 (2008-2011), respectively, were free of dementia and stroke, and did not have excessive alcohol intake. Between 2008 and 2011, participants underwent Multi-detector computed tomography scans of the abdomen to determine NAFLD diagnosis and the NFS was used to categorize the severity of fibrosis. Cross-sectional relationships of NAFLD and the NFS with cognitive testing of memory, abstract reasoning, visual perception, attention and executive function were assessed, while adjusting for multiple cardiometabolic variables including visceral adipose tissue, diabetes and insulin resistance.

Results: Of the 1287 participants (mean age = 61±12 years, 48% men), 378 (29%) had NAFLD. The presence of NAFLD was not associated with cognitive function. However, among those with NAFLD (mean age = 61±12 years; 58% men), high compared to low risk of advanced fibrosis was associated with poorer performance on similarities (β = -2.22 ± 0.83; P = 0.009) and trail-making B minus A (β = -0.11 ± 0.05; P = 0.028), independently of potential confounders.

Conclusions: Participants with high risk of advanced fibrosis may have poorer cognitive function compared to those with low risk, particularly in executive function and abstract reasoning. Future findings are necessary to evaluate the value of the NFS as a biomarker that predicts cognitive impairment and dementia and to explore the role of hepatic fibrosis in brain health.

Keywords: NAFLD fibrosis score; cognitive performance; liver fibrosis; non-alcoholic fatty liver disease.

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Conflict of interest statement

Conflict of interest:

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flow chart of the study sample NAFLD=Non-alcoholic Fatty Liver Disease
See this image and copyright information in PMC

Comment in

References

    1. Kannel WB, Sorlie P. Some health benefits of physical activity. The Framingham Study. Arch Intern Med. 1979;139(8):857–861. - PubMed
    1. Bertolotti M, Lonardo A, Mussi C, et al. Nonalcoholic fatty liver disease and aging: epidemiology to management. World journal of gastroenterology : WJG. 2014;20(39):14185–14204. - PMC - PubMed
    1. Yilmaz Y, Ozdogan O. Liver disease as a risk factor for cognitive decline and dementia: an under-recognized issue. Hepatology. 2009;49(2):698; author reply 698. - PubMed
    1. Seo SW, Gottesman RF, Clark JM, et al. Nonalcoholic fatty liver disease is associated with cognitive function in adults. Neurology. 2016;86(12):1136–1142. - PMC - PubMed
    1. Takahashi A, Kono S, Wada A, et al. Reduced brain activity in female patients with non-alcoholic fatty liver disease as measured by near-infrared spectroscopy. PloS one. 2017;12(4):e0174169. - PMC - PubMed

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