Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults: a systematic review and meta-analysis

Sue Shea; Christos Lionis; Chris Kite; Lukasz Lagojda; Olalekan A. Uthman; Alexander Dallaway; Lou Atkinson; Surinderjeet S. Chaggar; Harpal S. Randeva; Ioannis Kyrou

doi:10.3389/fendo.2024.1357664

Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults: a systematic review and meta-analysis

Sue Shea
, Christos Lionis
, Chris Kite
, Lukasz Lagojda
, Olalekan A. Uthman
, Alexander Dallaway
, Lou Atkinson
, Surinderjeet S. Chaggar
, Harpal S. Randeva
, Ioannis Kyrou

Frederick University
University of Wolverhampton
iPrescribe Exercise Digital Ltd (EXI)
Sowe Valley Primary Care Network
University of Chester
University of Warwick
University of Crete
Linköping University
University Hospitals Coventry and Warwickshire NHS Trust
Aston University
University of Derby
Agricultural University of Athens
Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism

Research output: Contribution to journal › Article › peer-review

39 Citations (Scopus)

42 Downloads (Pure)

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease, affecting 25-30% of the general population globally. The condition is even more prevalent in individuals with obesity and is frequently linked to the metabolic syndrome. Given the known associations between the metabolic syndrome and common mental health issues, it is likely that such a relationship also exists between NAFLD and mental health problems. However, studies in this field remain limited. Accordingly, the aim of this systematic review and meta-analysis was to explore the prevalence of one or more common mental health conditions (i.e., depression, anxiety, and/or stress) in adults with NAFLD. Methods: PubMed, EBSCOhost, ProQuest, Ovid, Web of Science, and Scopus were searched in order to identify studies reporting the prevalence of depression, anxiety, and/or stress among adults with NAFLD. A random-effects model was utilized to calculate the pooled prevalence and confidence intervals for depression, anxiety and stress. Results: In total, 31 studies were eligible for inclusion, involving 2,126,593 adults with NAFLD. Meta-analyses yielded a pooled prevalence of 26.3% (95% CI: 19.2 to 34) for depression, 37.2% (95% CI: 21.6 to 54.3%) for anxiety, and 51.4% (95% CI: 5.5 to 95.8%) for stress among adults with NAFLD. Conclusion: The present findings suggest a high prevalence of mental health morbidity among adults with NAFLD. Given the related public health impact, this finding should prompt further research to investigate such associations and elucidate potential associations between NAFLD and mental health morbidity, exploring potential shared underlying pathophysiologic mechanisms. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021288934.

Original language	English
Article number	1357664
Number of pages	16
Journal	Frontiers in Endocrinology
Volume	15
Early online date	16 Apr 2024
DOIs	https://doi.org/10.3389/fendo.2024.1357664
Publication status	Published - 2024

Bibliographical note

© 2024 Shea, Lionis, Kite, Lagojda, Uthman, Dallaway, Atkinson, Chaggar, Randeva and Kyrou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

non-alcoholic fatty liver disease
depression
stress
NASH
NAFLD
mental health
anxiety

Access to Document

10.3389/fendo.2024.1357664Licence: CC BY

Kyrou2024VoRFinal published version, 1.96 MBLicence: CC BY

Cite this

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title = "Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults: a systematic review and meta-analysis",

abstract = "Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease, affecting 25-30\% of the general population globally. The condition is even more prevalent in individuals with obesity and is frequently linked to the metabolic syndrome. Given the known associations between the metabolic syndrome and common mental health issues, it is likely that such a relationship also exists between NAFLD and mental health problems. However, studies in this field remain limited. Accordingly, the aim of this systematic review and meta-analysis was to explore the prevalence of one or more common mental health conditions (i.e., depression, anxiety, and/or stress) in adults with NAFLD. Methods: PubMed, EBSCOhost, ProQuest, Ovid, Web of Science, and Scopus were searched in order to identify studies reporting the prevalence of depression, anxiety, and/or stress among adults with NAFLD. A random-effects model was utilized to calculate the pooled prevalence and confidence intervals for depression, anxiety and stress. Results: In total, 31 studies were eligible for inclusion, involving 2,126,593 adults with NAFLD. Meta-analyses yielded a pooled prevalence of 26.3\% (95\% CI: 19.2 to 34) for depression, 37.2\% (95\% CI: 21.6 to 54.3\%) for anxiety, and 51.4\% (95\% CI: 5.5 to 95.8\%) for stress among adults with NAFLD. Conclusion: The present findings suggest a high prevalence of mental health morbidity among adults with NAFLD. Given the related public health impact, this finding should prompt further research to investigate such associations and elucidate potential associations between NAFLD and mental health morbidity, exploring potential shared underlying pathophysiologic mechanisms. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021288934.",

keywords = "non-alcoholic fatty liver disease, depression, stress, NASH, NAFLD, mental health, anxiety",

author = "Sue Shea and Christos Lionis and Chris Kite and Lukasz Lagojda and Uthman, \{Olalekan A.\} and Alexander Dallaway and Lou Atkinson and Chaggar, \{Surinderjeet S.\} and Randeva, \{Harpal S.\} and Ioannis Kyrou",

note = "{\textcopyright} 2024 Shea, Lionis, Kite, Lagojda, Uthman, Dallaway, Atkinson, Chaggar, Randeva and Kyrou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.",

year = "2024",

doi = "10.3389/fendo.2024.1357664",

language = "English",

volume = "15",

journal = "Frontiers in Endocrinology",

issn = "1664-2392",

publisher = "Frontiers Media S.A.",

}

TY - JOUR

T1 - Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults

T2 - a systematic review and meta-analysis

AU - Shea, Sue

AU - Lionis, Christos

AU - Kite, Chris

AU - Lagojda, Lukasz

AU - Uthman, Olalekan A.

AU - Dallaway, Alexander

AU - Atkinson, Lou

AU - Chaggar, Surinderjeet S.

AU - Randeva, Harpal S.

AU - Kyrou, Ioannis

N1 - © 2024 Shea, Lionis, Kite, Lagojda, Uthman, Dallaway, Atkinson, Chaggar, Randeva and Kyrou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

PY - 2024

Y1 - 2024

N2 - Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease, affecting 25-30% of the general population globally. The condition is even more prevalent in individuals with obesity and is frequently linked to the metabolic syndrome. Given the known associations between the metabolic syndrome and common mental health issues, it is likely that such a relationship also exists between NAFLD and mental health problems. However, studies in this field remain limited. Accordingly, the aim of this systematic review and meta-analysis was to explore the prevalence of one or more common mental health conditions (i.e., depression, anxiety, and/or stress) in adults with NAFLD. Methods: PubMed, EBSCOhost, ProQuest, Ovid, Web of Science, and Scopus were searched in order to identify studies reporting the prevalence of depression, anxiety, and/or stress among adults with NAFLD. A random-effects model was utilized to calculate the pooled prevalence and confidence intervals for depression, anxiety and stress. Results: In total, 31 studies were eligible for inclusion, involving 2,126,593 adults with NAFLD. Meta-analyses yielded a pooled prevalence of 26.3% (95% CI: 19.2 to 34) for depression, 37.2% (95% CI: 21.6 to 54.3%) for anxiety, and 51.4% (95% CI: 5.5 to 95.8%) for stress among adults with NAFLD. Conclusion: The present findings suggest a high prevalence of mental health morbidity among adults with NAFLD. Given the related public health impact, this finding should prompt further research to investigate such associations and elucidate potential associations between NAFLD and mental health morbidity, exploring potential shared underlying pathophysiologic mechanisms. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021288934.

AB - Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease, affecting 25-30% of the general population globally. The condition is even more prevalent in individuals with obesity and is frequently linked to the metabolic syndrome. Given the known associations between the metabolic syndrome and common mental health issues, it is likely that such a relationship also exists between NAFLD and mental health problems. However, studies in this field remain limited. Accordingly, the aim of this systematic review and meta-analysis was to explore the prevalence of one or more common mental health conditions (i.e., depression, anxiety, and/or stress) in adults with NAFLD. Methods: PubMed, EBSCOhost, ProQuest, Ovid, Web of Science, and Scopus were searched in order to identify studies reporting the prevalence of depression, anxiety, and/or stress among adults with NAFLD. A random-effects model was utilized to calculate the pooled prevalence and confidence intervals for depression, anxiety and stress. Results: In total, 31 studies were eligible for inclusion, involving 2,126,593 adults with NAFLD. Meta-analyses yielded a pooled prevalence of 26.3% (95% CI: 19.2 to 34) for depression, 37.2% (95% CI: 21.6 to 54.3%) for anxiety, and 51.4% (95% CI: 5.5 to 95.8%) for stress among adults with NAFLD. Conclusion: The present findings suggest a high prevalence of mental health morbidity among adults with NAFLD. Given the related public health impact, this finding should prompt further research to investigate such associations and elucidate potential associations between NAFLD and mental health morbidity, exploring potential shared underlying pathophysiologic mechanisms. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021288934.

KW - non-alcoholic fatty liver disease

KW - depression

KW - stress

KW - NASH

KW - NAFLD

KW - mental health

KW - anxiety

UR - https://www.scopus.com/pages/publications/85192145030

U2 - 10.3389/fendo.2024.1357664

DO - 10.3389/fendo.2024.1357664

M3 - Article

SN - 1664-2392

VL - 15

JO - Frontiers in Endocrinology

JF - Frontiers in Endocrinology

M1 - 1357664

ER -

Non-alcoholic fatty liver disease and coexisting depression, anxiety and/or stress in adults: a systematic review and meta-analysis

Abstract

Bibliographical note

UN SDGs

Keywords

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