Investigating the Link Between Smoking and Fatty Liver via Ultrasound Elastography: A Cross-Sectional Analysis Study

To investigate the link between smoking and fatty liver, particularly the influence of different smoking patterns on its prevalence, aiming to provide insights for public health policies.

We conducted a cross-sectional analysis of data from 6140 adults participating in the NHANES between 2017 and 2020. Participants were categorized into nonsmoking, secondhand smoke exposure, and active smoking groups based on serum cotinine levels. Multivariable regression models were used to assess the associations between smoking status and fatty liver, controlling for potential confounders.

Active smokers showed a significantly higher prevalence of fatty liver compared to nonsmokers, especially among obese subgroups. In obese populations, both active smoking and secondhand smoke exposure remarkably increased the risk of fatty liver (OR = 2.51, p = 0.014). In contrast, a negative but statistically nonsignificant association was found between smoking and fatty liver in nonobese individuals.

Therefore, smoking, particularly among obese individuals, is a significant contributor to fatty liver. Raising public awareness of the risks associated with smoking could help enhance liver health and overall quality of life.