"Young Adults with Depressive Symptoms Face Up to Twice the Risk of Fatty Liver"

Analysis of Korean Adults Aged 19 to 44
First Study on the Link Between Depressive Symptoms and Fatty Liver

A new study published in an international academic journal found that young Korean adults with depressive symptoms have roughly twice the risk of developing fatty liver compared to those without such symptoms. The research also showed that the more severe the depressive symptoms, the higher the risk of fatty liver.

According to Seoul St. Mary's Hospital of the Catholic University of Korea on July 28, a research team led by Professor Heo Yeon (joint first author) of the Department of Family Medicine at Seoul St. Mary's Hospital, Professor Oh Sanghun (joint first author) of the Department of Psychiatry at Uijeongbu Eulji Medical Center, Eulji University, and Professor Nam Gaeun (corresponding author) of the Department of Family Medicine at Korea University Guro Hospital, analyzed the association between depressive symptoms and fatty liver among 7,831 adults aged 19 to 44, selected from 10,955 participants in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2022. Those who tested positive for hepatitis B or C, or who engaged in moderate or higher levels of alcohol consumption, among others, were excluded. Depressive symptoms were assessed using the internationally validated screening tool PHQ-9 (Patient Health Questionnaire-9), while fatty liver was defined based on the Hepatic Steatosis Index (HSI).

Depression Symptoms and Fatty Liver Index Graph. Seoul St. Mary's Hospital

Among individuals with depressive symptoms (PHQ-9 score of 10 or above), the prevalence of fatty liver was 33.9%, significantly higher than the 23.8% observed in those without depressive symptoms. After adjusting for various socioeconomic factors, lifestyle habits, and comorbidities, the study still found that people with depressive symptoms had about twice the risk of fatty liver.

The study also confirmed that the risk of fatty liver increased with the severity of depressive symptoms. Compared to those with minimal depressive symptoms (PHQ-9 score 0–4), individuals with moderate depressive symptoms (PHQ-9 score 10–14) had approximately 1.95 times higher risk, while those with severe depressive symptoms (PHQ-9 score of 15 or higher) had about 2.41 times higher risk. Furthermore, statistical analysis revealed that the association between depressive symptoms and fatty liver was even stronger among young adults with obesity or dyslipidemia. This suggests that metabolically vulnerable young people are more affected by depressive symptoms in relation to fatty liver.

Most previous studies on depressive symptoms and fatty liver have focused on middle-aged and older adults, Western populations, or specific high-risk groups. As a result, there has been a lack of research on young Asians, in whom metabolic abnormalities appear relatively early and the prognosis may be improved through lifestyle changes. This study is meaningful in that it is the first to analyze the association between depressive symptoms and fatty liver in a representative sample of young Korean adults, thus addressing these research gaps.

Professor Heo Yeon of the Department of Family Medicine at Seoul St. Mary's Hospital said, "This study was initiated after frequently encountering cases in clinical practice where chronic diseases emerging in youth affected health outcomes later in life. Our findings confirm that depressive symptoms are closely associated not only with mental health issues, but also with metabolic diseases such as fatty liver. Therefore, it is essential to provide integrated management for young people with depressive symptoms, assessing not only their mental health but also metabolic health, including weight, blood sugar, lipid levels, and liver health."

Professor Nam Gaeun of the Department of Family Medicine at Korea University Guro Hospital added, "Since fatty liver in youth can increase future risks of liver and cardiovascular diseases, it is important to detect and appropriately manage depressive symptoms in young adults at an early stage. There is also a need for future prospective studies to clarify the causal relationship between depressive symptoms and fatty liver."

This research was recently published in the international academic journal Psychiatry Research.

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