{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:43:30Z","timestamp":1792421010981,"version":"4.5.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec014\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between cigarette smoking and nonalcoholic fatty liver disease (NAFLD) remains controversial. Recent studies have demonstrated that cigarette smoking is a significant risk factor for the development of NAFLD. This study aimed to examine the association between smoking and NAFLD according to smoking status among Korean males, and to examine the relationship between smoking cessation and NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec015\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included data from 12,241 adult males who underwent health checkups at a university hospital health promotion center between January 2018 and December 2019. Fatty liver was diagnosed using abdominal ultrasonography. The participants were categorized according to self-reported smoking status, pack-years, and period of smoking cessation. Odds ratio (OR) and corresponding 95% confidence interval (CI) for NAFLD were calculated using logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec016\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for confounding factors, the OR for NAFLD was 1.190 (95% CI 1.071\u20131.322,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u2009.001) among ex-smokers. Among current smokers, the risk for NAFLD increased with an increase in the amount of cigarette smoking (10\u201320 and \u226520 pack-years versus [vs.] never smoker, adjusted OR [aOR] 1.289 [95% CI 1.107\u20131.500];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.001 and 1.235 [95% CI 1.043\u20131.461]). The prevalence of NAFLD was inversely associated with the duration of smoking cessation (&lt; 10 years vs. 10\u201320 years and \u2265 20 years; aOR 0.748 [95% CI 0.638\u20130.876],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001 and 0.750 [95% CI 0.592\u20130.950],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.017, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec017\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cigarette smoking was significantly associated with increased odds of NAFLD, whereas smoking cessation for more than 10 years was associated with decreased odds.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0325305","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T13:46:38Z","timestamp":1749476798000},"page":"e0325305","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association between smoking status and non-alcoholic fatty liver disease"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5134-2866","authenticated-orcid":true,"given":"Hyun","family":"Joe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Eun","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Jin","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwang-Sik","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"issue":"6","key":"pone.0325305.ref001","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1002\/hep.25762","article-title":"The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association","volume":"55","author":"N Chalasani","year":"2012","journal-title":"Hepatology"},{"issue":"2","key":"pone.0325305.ref002","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.cld.2015.10.001","article-title":"Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in the United States and the Rest of the World","volume":"20","author":"M Sayiner","year":"2016","journal-title":"Clin Liver Dis"},{"issue":"7","key":"pone.0325305.ref003","doi-asserted-by":"crossref","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease","volume":"158","author":"M Eslam","year":"2020","journal-title":"Gastroenterology"},{"issue":"5","key":"pone.0325305.ref004","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/S2468-1253(19)30039-1","article-title":"Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis","volume":"4","author":"J Li","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"2","key":"pone.0325305.ref005","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jhep.2017.09.021","article-title":"Hypertension, diabetes, atherosclerosis and NASH: cause or consequence?","volume":"68","author":"A Lonardo","year":"2018","journal-title":"J Hepatol"},{"issue":"2","key":"pone.0325305.ref006","doi-asserted-by":"crossref","first-page":"168","DOI":"10.5009\/gnl19069","article-title":"Extrahepatic Manifestations of Nonalcoholic Fatty Liver Disease","volume":"14","author":"AA Li","year":"2020","journal-title":"Gut Liver"},{"issue":"5","key":"pone.0325305.ref007","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1111\/jgh.13264","article-title":"Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. 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