Exploring the link between non-alcoholic fatty liver disease and depression: a systematic review and meta-analysis of bidirectional risk.

Objective: This study aims to consolidate evidence regarding the occurrence of depression among non-alcoholic fatty liver disease (NAFLD) patients and explore the bidirectional relationship between NAFLD and depression.

Methods: Three major databases: Medline, Google Scholar, and ScienceDirect, were searched for relevant studies published up to August 2023 that report the incidence of depression in patients with NAFLD and investigate a correlation between NAFLD and depression. The quality of the studies was evaluated using the Joanna Briggs Institute checklist. The final pooled prevalence was reported with a 95% confidence interval (CI), and the pooled incidence of depression among NAFLD patients was summarized as a pooled Odds ratios (OR) with a 95% CI.

Results: A total of 16 studies were included in the analysis. The pooled prevalence of depression (15 studies) among NAFLD patients was 19% (95% CI: 16%-22%) (P-value < 0.001). Patients with NAFLD had a 28%-increased risk (OR 1.28, 95% CI: 1.06-1.55, P-value < 0.001) of developing depression compared to non-NAFLD patients (10 studies). Conversely, patients with depression had 2.32 times higher odds (OR 2.32, 95% CI: 1.13-4.78, P-value 0.03) of developing NAFLD (two studies). Subgroup analyses based on sample size and geographic region revealed variations in prevalence estimates.

Conclusion: Robust evidence supported a bidirectional link between NAFLD and depression. These findings underscore the importance of comprehensive patient care strategies that encompass both physical and mental well-being.