Young adults with symptoms of depression may face more than double the risk of developing fatty liver disease compared with those without depressive symptoms, according to a new South Korean study.
Researchers led by Dr. Yeon Huh of the Department of Family Medicine at Seoul St. Mary’s Hospital, Dr. Sang Hoon Oh of Uijeongbu Eulji University Hospital, and Dr. Ga Eun Nam of Korea University Guro Hospital analyzed data from 7,831 adults aged 19 to 44 who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) between 2014 and 2022.
The researchers evaluated 7,831 participants after excluding individuals with hepatitis B or C infection and those with moderate or heavy alcohol consumption from an initial pool of 10,955 adults.
Depressive symptoms were assessed using the internationally recognized Patient Health Questionnaire-9 (PHQ-9), while fatty liver disease was evaluated using the Hepatic Steatosis Index (HSI).
Fatty liver disease occurs when excessive fat accumulates in liver cells. Although it often causes no symptoms in its early stages, untreated fatty liver can progress to steatohepatitis, increasing the risk of liver cirrhosis and liver cancer. It is also increasingly recognized as a metabolic disorder associated with obesity, diabetes, and cardiovascular disease, highlighting the importance of early detection and management.
The analysis found that 33.9% of participants with depressive symptoms (PHQ-9 score of 10 or higher) had fatty liver disease, compared with 23.8% of those without depressive symptoms.
After adjusting for socioeconomic factors, lifestyle habits, and other underlying health conditions, young adults with depressive symptoms remained approximately twice as likely to have fatty liver disease.
The risk increased as depression severity worsened.
Compared with participants reporting minimal depressive symptoms (PHQ-9 scores of 0–4), those with moderate depression (PHQ-9 scores of 10–14) had 1.95 times the risk of fatty liver disease, while those with severe depressive symptoms (PHQ-9 scores of 15 or higher) had a 2.41-fold higher risk.
The association was particularly strong among young adults with obesity or dyslipidemia, suggesting that depression may have a greater impact on liver health in individuals who are already metabolically vulnerable.
The researchers noted that previous studies have largely focused on middle-aged or older adults, Western populations, or high-risk groups. They said this is the first study to examine the relationship between depressive symptoms and fatty liver disease using a nationally representative sample of young Korean adults.
“Depressive symptoms are not simply a mental health issue—they are also closely linked to metabolic diseases such as fatty liver disease,” Dr. Huh said. “Young adults experiencing depression should receive integrated care that addresses not only mental health, but also body weight, blood glucose, lipid levels, and liver health.”
Dr. Nam added that early identification and management of depression in young adults is essential.
“Future prospective studies are needed to clarify whether depressive symptoms directly contribute to the development of fatty liver disease,” she said.
The findings were recently published in the international journal Psychiatry Research.