The Association between Educational Attainment and the Risk of Nonalcoholic Fatty Liver Disease among Chinese Adults: Findings from the REACTION Study
- Author:
Yuanyue ZHU
1
;
Long WANG
;
Lin LIN
;
Yanan HUO
;
Qin WAN
;
Yingfen QIN
;
Ruying HU
;
Lixin SHI
;
Qing SU
;
Xuefeng YU
;
Li YAN
;
Guijun QIN
;
Xulei TANG
;
Gang CHEN
;
Shuangyuan WANG
;
Hong LIN
;
Xueyan WU
;
Chunyan HU
;
Mian LI
;
Min XU
;
Yu XU
;
Tiange WANG
;
Zhiyun ZHAO
;
Zhengnan GAO
;
Guixia WANG
;
Feixia SHEN
;
Xuejiang GU
;
Zuojie LUO
;
Li CHEN
;
Qiang LI
;
Zhen YE
;
Yinfei ZHANG
;
Chao LIU
;
Youmin WANG
;
Shengli WU
;
Tao YANG
;
Huacong DENG
;
Lulu CHEN
;
Tianshu ZENG
;
Jiajun ZHAO
;
Yiming MU
;
Weiqing WANG
;
Guang NING
;
Yufang BI
;
Yuhong CHEN
;
Jieli LU
Author Information
- Publication Type:Original Article
- From:Gut and Liver 2024;18(4):719-728
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background/Aims:Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China.
Methods:A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators.
Results:Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders.
Conclusions:In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.
