{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:13:25Z","timestamp":1787620405860,"version":"build-2736575974"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"unspecified","delay-in-days":70,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>\n\t    <jats:bold>Abstract<\/jats:bold>\n\t  <\/jats:p>\n\t  <jats:sec id=\"S204579602000116X_sec_a1\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>The longitudinal relationship between depression and the risk of non-alcoholic fatty liver disease is uncertain. We examined: (a) the association between depressive symptoms and incident hepatic steatosis (HS), both with and without liver fibrosis; and (b) the influence of obesity on this association.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S204579602000116X_sec_a2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A cohort of 142 005 Korean adults with neither HS nor excessive alcohol consumption at baseline were followed for up to 8.9 years. The validated Center for Epidemiologic Studies-Depression score (CES-D) was assessed at baseline, and subjects were categorised as non-depressed (a CES-D &lt; 8, reference) or depression (CES-D \u2a7e 16). HS was diagnosed by ultrasonography. Liver fibrosis was assessed by the fibrosis-4 index (FIB-4). Parametric proportional hazards models were used to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S204579602000116X_sec_a3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>During a median follow-up of 4.0 years, 27 810 people with incident HS and 134 with incident HS plus high FIB-4 were identified. Compared with the non-depressed category, the aHR (95% CIs) for incident HS was 1.24 (1.15\u20131.34) for CES-D \u2a7e 16 among obese individuals, and 1.00 (0.95\u20131.05) for CES-D \u2a7e 16 among non-obese individuals (<jats:italic>p<\/jats:italic> for interaction with obesity &lt;0.001). The aHR (95% CIs) for developing HS plus high FIB-4 was 3.41 (1.33\u20138.74) for CES-D \u2a7e 16 among obese individuals, and 1.22 (0.60\u20132.47) for CES-D \u2a7e 16 among non-obese individuals (<jats:italic>p<\/jats:italic> for interaction = 0.201).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S204579602000116X_sec_a4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Depression was associated with an increased risk of incident HS and HS plus high probability of advanced fibrosis, especially among obese individuals.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s204579602000116x","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T06:40:03Z","timestamp":1615531203000},"source":"Crossref","is-referenced-by-count":58,"title":["Depression and increased risk of non-alcoholic fatty liver disease in individuals with obesity"],"prefix":"10.1017","volume":"30","author":[{"given":"In 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