Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
Nutr Metab Cardiovasc Dis. 2013 Dec;23(12):1231-8. doi: 10.1016/j.numecd.2013.02.004. Epub 2013 Apr 1.
Fatty liver index (FLI), a surrogate parameter for nonalcoholic fatty liver disease, is an emerging risk factor for cardiovascular diseases and mortality. We aimed to evaluate whether FLI is associated with all-cause, cardiovascular, and non-cardiovascular mortality as well as fatal cancer in a cohort of subjects routinely referred to coronary angiography.
FLI was calculated using BMI (body mass index), waist circumference (WC), triglycerides (TG) and gamma-glutamyl transferase (GGT) in 3270 subjects who were referred to coronary angiography (1997-2000). The main outcome measures were Cox proportional hazard ratios (HRs) for mortality from all causes, cardiovascular causes, non-cardiovascular causes, and fatal cancer. After a median follow-up time of 7.7 years, 740 subjects (22.6%) had died. There were 437 deaths due to cardiovascular disease and 303 deaths due to non-cardiovascular disease. Age-, sex-, and BMI-adjusted HRs (with 95% confidence intervals) for all-cause, cardiovascular, and non-cardiovascular mortality in the highest compared to the lowest FLI quartile were 2.56 (1.90-3.43; p < 0.001), 2.17 (1.47-3.22; p < 0.001), and 3.49 (2.16-5.66; p < 0.001), respectively. In age-, sex-, and BMI-adjusted analyzes, we found no significant association of FLI with fatal cancer. Multivariate adjusted HRs for all-cause, cardiovascular, non-cardiovascular mortality, and fatal cancer in the highest compared to the lowest FLI quartile were 2.17 (1.58-2.99; p < 0.001), 1.64 (1.07-2.51; p = 0.023), 3.72 (2.22-6.24; p < 0.001), and 2.33 (1.01-5.41; p = 0.048) respectively.
In subjects referred to coronary angiography, high FLI levels are independently associated with increased all-cause, cardiovascular, and non-cardiovascular mortality as well as fatal cancer.
非酒精性脂肪肝指数（FLI）是一种非酒精性脂肪肝的替代参数，它是心血管疾病和死亡的新兴危险因素。我们旨在评估 FLI 是否与常规接受冠状动脉造影检查的患者的全因、心血管和非心血管死亡率以及致命性癌症相关。
在 3270 名接受冠状动脉造影检查的患者（1997-2000 年）中，使用 BMI（体重指数）、腰围（WC）、甘油三酯（TG）和γ-谷氨酰转移酶（GGT）计算 FLI。主要观察终点是全因、心血管原因、非心血管原因和致命性癌症死亡的 Cox 比例风险比（HR）。中位随访时间为 7.7 年后，740 名患者（22.6%）死亡。其中，心血管疾病死亡 437 例，非心血管疾病死亡 303 例。与 FLI 最低四分位数相比，最高四分位数的全因、心血管和非心血管死亡率的年龄、性别和 BMI 调整 HR（95%置信区间）分别为 2.56（1.90-3.43；p<0.001）、2.17（1.47-3.22；p<0.001）和 3.49（2.16-5.66；p<0.001）。在年龄、性别和 BMI 调整分析中，我们未发现 FLI 与致命性癌症有显著关联。与 FLI 最低四分位数相比，最高四分位数的全因、心血管、非心血管死亡率和致命性癌症的多变量调整 HR 分别为 2.17（1.58-2.99；p<0.001）、1.64（1.07-2.51；p=0.023）、3.72（2.22-6.24；p<0.001）和 2.33（1.01-5.41；p=0.048）。
在接受冠状动脉造影检查的患者中，高 FLI 水平与全因、心血管和非心血管死亡率以及致命性癌症的增加独立相关。
