Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population.
10.1097/CM9.0000000000002754
- VernacularTitle:Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population
- Author:
Yuanjie PANG
1
;
Jun LV
1
;
Christiana KARTSONAKI
2
;
Canqing YU
1
;
Yu GUO
3
;
Yiping CHEN
2
;
Ling YANG
2
;
Iona Y MILLWOOD
2
;
Robin G WALTERS
2
;
Silu LV
4
;
Sushila BURGESS
2
;
Sam SANSOME
2
;
Junshi CHEN
5
;
Zhengming CHEN
2
;
Liming LI
1
Author Information
1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
2. Nuffield Department of Population Health, Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Oxford OX37LF, UK.
3. National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Beijing 100730, China.
4. Licang Center for Disease Prevention and Control, Licang District, Qingdao, Shandong 266041, China.
5. National Center for Food Safety Risk Assessment, Beijing 100021, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Prospective Studies;
Incidence;
East Asian People;
Healthy Lifestyle;
Risk Factors;
Liver Neoplasms;
Prognosis;
China/epidemiology*
- From:
Chinese Medical Journal
2023;136(16):1929-1936
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Severe liver disease (SLD), including cirrhosis and liver cancer, constitutes a major disease burden in China. We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.
METHODS:The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years. The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors (smoking, alcohol, physical activity, and central adiposity). Additionally, the contribution of genetic risk for hepatitis B virus (HBV, assessed by genetic variants in major histocompatibility complex, class II, DP/DQ [ HLA - DP / DQ ] genes) was also estimated.
RESULTS:Compared with those with 0-1 healthy lifestyle factor, participants with 2, 3, and 4 factors had 12% (HR 0.88 [95% confidence interval [CI] 0.85, 0.92]), 26% (HR 0.74 [95%CI: 0.69, 0.79]), and 44% (HR 0.56 [95%CI: 0.48, 0.65]) lower risks of SLD, respectively. Inverse associations were observed among participants with both low and high genetic risks (HR per 1-point increase 0.83 [95%CI: 0.74, 0.94] and 0.91 [95%CI: 0.82, 1.02], respectively; Pinteraction = 0.51), although with a non-significant trend among those with a high genetic risk. Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk. Despite the limited power, healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk (HR 0.59 [95%CI: 0.37, 0.96]).
CONCLUSIONS:Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk. Moreover, it is also important for improving the prognosis of SLD in individuals with a low genetic risk. Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis, particularly among individuals with a high genetic risk.
