ArticleFrontiers in endocrinology2021
Autonomic Imbalance Increases the Risk for Non-alcoholic Fatty Liver Disease.
Article in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Effects of sleep deprivation on heart rate variability: a systematic review and meta-analysis.Frontiers in neurology · 2025Pooled it
- Peripheral and Autonomic Diabetic Neuropathy and Their Additive Risk of Major Adverse Liver Outcomes in Type 2 Diabetes.Advances in therapy · 2026Article
- Circadian Blood Pressure Patterns in Adults with Moderate-to-Severe Hepatic Steatosis: A Prospective Ambulatory Blood Pressure Monitoring Study.Journal of clinical medicine · 2026Article
- Liver-nervous system axis: pathways, dysregulation, and translational perspectives.Journal of neuroinflammation · 2026Review
- Renal Denervation Improves Hepatic Steatosis in Hypertensive Patients With Metabolic Syndrome.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Liver clock: Malalignment and entrainment therapeutics.World journal of gastrointestinal pharmacology and therapeutics · 2026Review
- Role of central and peripheral serotonin in liver physiology and diseases.Theranostics · 2026Review
- Liver-nervous system axis in MASLD: mechanistic insights and emerging targeted therapies.eGastroenterology · 2026Review
- Article
- Beta-cell, but not autonomic nervous system, function is related to MAFLD in early stages of glucose intolerance.BMJ open diabetes research & care · 2024Article
- Interaction between the systemic immune-inflammation index and trouble sleeping in nonalcoholic fatty liver disease: a cross-sectional study of the NHANES 2005-2018 data.Journal of health, population, and nutrition · 2024Article
- The Neuroimmune Axis and Its Therapeutic Potential for Primary Liver Cancer.International journal of molecular sciences · 2024Review
- Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective.Diabetes & metabolism journal · 2024Review
- Associations of ALT/AST, a marker of hepatosteatosis, with pulse rate in young women and with blood pressure in middle-aged women independently of abdominal fat accumulation and insulin resistance.Diabetology international · 2024Article
- The Sympathetic-Immune Milieu in Metabolic Health and Diseases: Insights from Pancreas, Liver, Intestine, and Adipose Tissues.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Review
- Multi-Organ Increase in Norepinephrine Levels after Central Leptin Administration and Diet-Induced Obesity.International journal of molecular sciences · 2023Article
- Hepatic Innervations and Nonalcoholic Fatty Liver Disease.Seminars in liver disease · 2023Review
- The Role of the Stress Response in Metabolic Dysfunction-Associated Fatty Liver Disease: A Psychoneuroendocrineimmunology-Based Perspective.Nutrients · 2023Article
- Heart failure with preserved ejection fraction and non-alcoholic fatty liver disease: new insights from bioinformatics.ESC heart failure · 2023Article
- Assessment of sympathovagal balance by HRV analysis in alcoholic and nonalcoholic fatty liver disease patients.Journal of education and health promotion · 2023Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although autonomic imbalance is associated with an increased risk for metabolic disease, its effects on nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to evaluate whether autonomic dysfunction predicts the risk for nonalcoholic fatty liver disease (NAFLD). Methods: A total of 33,899 participants without NAFLD who underwent health screening programs between 2011 and 2018 were enrolled. NAFLD was identified by ultrasonography. Autonomic activity was estimated using heart rate variability (HRV). Time domain [standard deviation of the normal-to-normal interval (SDNN) and root mean square difference (RMSSD)]; frequency domain [total power (TP), low frequency (LF), and high frequency (HF), and LF/HF ratio were analyzed. Findings: A total 6,466 participants developed NAFLD within a median of 5.7 years. Subjects with incident NAFLD showed decreased overall autonomic modulation and vagal activity with lowered SDNN, RMSSD, HF, normalized HF, compared to those without NAFLD. As the SDNN, RMSSD, TP, LF, and HF tertiles increased, the risk of NAFLD decreased with tertile 1 being the reference group [the hazard ratios (95% confidence intervals) of tertile 3 were 0.90 (0.85-0.96), 0.83 (0.78-0.88), 0.91 (0.86-0.97), 0.93 (0.87-0.99) and 0.89 (0.83-0.94), respectively] after adjusting for potential confounders. The risk for NAFLD was significantly higher in subjects in whom sustained elevated heart rate, normalized LF, and LF/HF ratio values than in those with sustained decrease in these parameters during follow-up. Conclusions: Overall autonomic imbalance, decreased parasympathetic activity, and recently increased sympathetic activity might increase the risk of NAFLD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.