Association between depressive symptoms and hepatic steatosis in young adults: a nationwide study

Hepatic steatosis is a growing global health concern associated with cardiometabolic diseases. There is limited evidence regarding the association between depressive symptoms and hepatic steatosis in young adults. We aimed to investigate these associations in young Korean adults.

This cross-sectional study included 7,831 adults aged 19-44 years who participated in the Korea National Health and Nutrition Examination Survey between 2014 and 2022. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and categorized as no elevated depressive symptoms or elevated depressive symptoms and into four severity groups (minimal, mild, moderate, and severe). Hepatic steatosis was defined as a hepatic steatosis index of ≥36. Multivariable logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

The prevalence of hepatic steatosis was 23.8% and 33.9% in individuals without and with elevated depressive symptoms, respectively. After adjusting for potential confounders, the presence of elevated depressive symptoms was found to be associated with higher odds of hepatic steatosis (OR 2.01, 95% CI 1.54-2.64). Compared with individuals with minimal depressive symptoms, the ORs for hepatic steatosis increased with greater depressive symptom severity (1.95, 95% CI 1.41-2.70 for moderate and 2.41, 95% CI 1.49-3.88 for severe symptoms; P for trend <.001).

Elevated depressive symptoms and greater symptom severity were associated with increased odds of hepatic steatosis in young adults. These findings suggest that the assessment and management of metabolic and liver health are warranted in young adults presenting with depressive symptoms.