Chang Yoosoo, Cho Juhee, Cho Yong Kyun, Cho Ara, Hong Yun Soo, Zhao Di, Ahn Jiin, Sohn Chong Il, Shin Hocheol, Guallar Eliseo, Ryu Seungho
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Clin Gastroenterol Hepatol. 2020 Jan;18(1):205-215.e7. doi: 10.1016/j.cgh.2019.05.004. Epub 2019 May 11.
BACKGROUND & AIMS: We compared the associations of nonalcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (AFLD) with risk of incident hospitalization for liver and cardiovascular diseases.
We collected data from the Kangbuk Samsung Health Study on 218,030 men and women in Korea who underwent a health examination from 2011 through 2016. Fatty liver disease (FLD) was detected by ultrasound during the initial examination. The Fibrosis-4 index was used to identify individuals with liver fibrosis. Participants were followed up for as long as 5.9 years and data on hospitalizations for liver and cardiovascular diseases were collected.
The prevalence of NAFLD was 22.0% and the prevalence of AFLD was 6.4%. Over a median follow-up period of 4.2 years, we observed 51 and 1097 incident cases of liver disease- or cardiovascular disease-related hospitalizations, respectively. After adjustment for potential confounders, the multivariable-adjusted hazard ratios for liver disease-related hospitalization, comparing NAFLD and AFLD with the reference category (no excessive alcohol intake and no FLD), were 1.73 (95% CI, 0.76-3.96) and 5.00 (95% CI, 2.12-11.83), respectively. The corresponding hazard ratios for cardiovascular disease hospitalization were 1.20 (95% CI, 1.02-1.40) and 1.08 (95% CI, 0.86-1.34), respectively. Among participants with FLD, the risk of liver disease-related hospitalization increased with high Fibrosis-4 index scores, whereas the risk of incident cardiovascular disease did not.
In a large cohort study, we found an increased risk of liver disease-related hospitalizations for patients with NAFLD or AFLD, especially among those with Fibrosis-4 index scores. An increased risk of cardiovascular disease-associated hospitalization was observed in patients with NAFLD but not AFLD.
我们比较了非酒精性脂肪性肝病（NAFLD）和酒精性脂肪性肝病（AFLD）与肝脏和心血管疾病住院风险之间的关联。
我们收集了韩国江原三星健康研究中2011年至2016年期间接受健康检查的218,030名男性和女性的数据。在初次检查时通过超声检测脂肪肝疾病（FLD）。使用Fibrosis-4指数来识别肝纤维化患者。对参与者进行了长达5.9年的随访，并收集了肝脏和心血管疾病住院的数据。
NAFLD的患病率为22.0%，AFLD的患病率为6.4%。在中位随访期4.2年期间，我们分别观察到51例和1097例与肝脏疾病或心血管疾病相关的住院病例。在调整潜在混杂因素后，将NAFLD和AFLD与参考类别（无过量饮酒且无FLD）相比，肝脏疾病相关住院的多变量调整风险比分别为1.73（95%CI，0.76 - 3.96）和5.00（95%CI，2.12 - 11.83）。心血管疾病住院的相应风险比分别为1.20（95%CI，1.02 - 1.40）和1.08（95%CI，0.86 - 1.34）。在患有FLD的参与者中，肝脏疾病相关住院的风险随着Fibrosis-4指数得分的升高而增加，而心血管疾病的发病风险则没有。
在一项大型队列研究中，我们发现NAFLD或AFLD患者肝脏疾病相关住院的风险增加，尤其是那些Fibrosis-4指数得分较高的患者。在NAFLD患者中观察到心血管疾病相关住院风险增加，但在AFLD患者中未观察到。
