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Association of a lifestyle index with MRI-determined liver fat content in a general population study
  1. Manja Koch1,2,
  2. Jan Borggrefe3,
  3. Sabrina Schlesinger1,2,
  4. Janett Barbaresko2,4,
  5. Godo Groth5,
  6. Gunnar Jacobs6,
  7. Wolfgang Lieb1,
  8. Matthias Laudes7,
  9. Manfred J Müller8,
  10. Anja Bosy-Westphal9,
  11. Martin Heller5,
  12. Ute Nöthlings2,4
  1. 1Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany
  2. 2Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany
  3. 3Department of Radiology, University of Cologne, Cologne, Germany
  4. 4Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
  5. 5Clinic for Diagnostic Radiology, University Medical Center Schleswig-Holstein, Kiel, Germany
  6. 6PopGen Biobank, University Medical Center Schleswig-Holstein, Kiel, Germany
  7. 7Institute of Internal Medicine I, Christian-Albrechts University Kiel, Kiel, Germany
  8. 8Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany
  9. 9Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
  1. Correspondence to Manja Koch, Institute of Epidemiology, Christian-Albrechts University Kiel, Campus Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Straße 3, Haus 1, Kiel D-24105, Germany; manja.koch{at}


Background In prior studies, lifestyle indices were associated with numerous disease end points, but the association with fatty liver disease (FLD), a key correlate of cardiometabolic risk, is unknown. The aim was to investigate associations between a lifestyle index with liver fat content.

Methods Liver fat was quantified by MRI as liver signal intensity (LSI) in 354 individuals selected from a population-based cohort from Germany. Exposure to favourable lifestyle factors was quantified using an additive score with each factor modelled as a dichotomous trait. Favourable lifestyle factors were defined as waist circumference below 102 (men) or 88 cm (women), physical activity ≥3.5 h/week, never-smoking and a favourable dietary pattern, which was derived to explain liver fat variation. In a cross-sectional study, multivariable adjusted linear and logistic regression was applied to investigate the association between the lifestyle index (range 0–4, exposure) and LSI (modelled as a continuous trait or dichotomised as a FLD indicator variable, respectively).

Results Individuals with four favourable lifestyle factors (n=9%) had lower LSI values (ß −0.40; 95% CI −0.61 to −0.19) and a lower OR (0.09; 95% CI 0.03 to 0.30) for FLD compared with individuals with zero favourable lifestyle factors (n=10%).

Conclusions A healthy lifestyle pattern was associated with less liver fat. Prospective studies are warranted.

  • Epidemiology of chronic non communicable diseases

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