Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
BMJ Open. 2019 Sep 5;9(9):e031420. doi: 10.1136/bmjopen-2019-031420.
Fatty liver disease (FLD), a global epidemic, is also a predictor of cardiometabolic disease (CMD) (type 2 diabetes or cardiovascular disease). Our objective was to examine whether progressive FLD, as assessed by fatty liver index (FLI), predicts increasing future CMD risk compared with relatively stable FLD, among middle-aged men.
Prospective epidemiological study.
University affiliated research centre in Kuopio, Eastern Finland.
Our subjects were 501 men without CMD during the initial 4-year follow-up in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort.
Over the initial 4-year follow-up, 135 men (26.9%) had a significant (≥10) FLI increase. The association of 4-year FLI increase with incident CMD was analysed in multivariable-adjusted Cox regression models, adjusting for baseline constitutional and lifestyle factors (model 1) and, in addition, metabolic and inflammation biomarker factors (model 2).
During a mean follow-up of 15 years, 301 new CMD cases occurred. We used subjects with low baseline FLI and no significant 4-year FLI increase as the reference. For subjects with intermediate baseline FLI and significant 4-year FLI increase, the HRs and 95% CIs for incident CMD in model 1 (2.13 (1.45 to 3.13)) and model 2 (1.73 (1.13 to 2.66)) exceeded values for subjects with similar baseline FLI without a significant 4-year change (HRs (95% CIs) were 1.36 (0.94 to 1.97) for model 1 and 1.18 (0.81 to 1.70) for model 2). They approached HRs (95% CI) for subjects who maintained high FLI over the 4 years (HRs (95% CIs) were 2.18 (1.54 to 3.10) in model 1 and 1.85 (1.21 to 2.82) in model 2).
Persons with significant FLI increase are likely with increasing CMD risk. Such persons should be evaluated for progressive FLD and CMD and managed to reduce CMD risk.
脂肪肝疾病（FLD）是一种全球性的流行疾病，也是代谢心血管疾病（CMD）（2 型糖尿病或心血管疾病）的预测因素。我们的目的是检验在中年男性中，是否与相对稳定的 FLD 相比，通过脂肪性肝指数（FLI）评估的进行性 FLD 能够预测未来 CMD 风险的增加。
前瞻性流行病学研究。
芬兰东部库奥皮奥大学附属研究中心。
我们的研究对象是库奥皮奥缺血性心脏病风险因素研究队列中，在最初的 4 年随访期间没有 CMD 的 501 名男性。
在最初的 4 年随访期间，有 135 名男性（26.9%）的 FLI 显著增加（≥10）。采用多变量调整 Cox 回归模型分析 4 年 FLI 增加与新发 CMD 的关系，模型 1 中调整基线体质和生活方式因素（模型 1），另外，还调整代谢和炎症生物标志物因素（模型 2）。
在平均 15 年的随访期间，发生了 301 例新的 CMD 病例。我们将低基线 FLI 和 4 年内无显著 FLI 增加的患者作为参考。对于基线 FLI 中等且 4 年内 FLI 显著增加的患者，模型 1（2.13[1.45-3.13]）和模型 2（1.73[1.13-2.66]）中 CMD 的 HR 和 95%CI 值高于基线 FLI 相似且 4 年内无显著变化的患者（HRs[95%CI]为 1.36[0.94-1.97]，模型 1和 1.18[0.81-1.70]，模型 2）。与那些在 4 年内持续高 FLI 的患者的 HRs（95%CI）接近（模型 1 中的 HRs（95%CI）为 2.18[1.54-3.10]，模型 2 中的 HRs（95%CI）为 1.85[1.21-2.82]）。
FLI 显著增加的患者可能具有更高的 CMD 风险。此类患者应评估进行性 FLD 和 CMD，并进行管理以降低 CMD 风险。
