“生命七要素”与非酒精性脂肪性肝病：动脉粥样硬化的多种族研究。

Life's Simple 7 and Nonalcoholic Fatty Liver Disease: The Multiethnic Study of Atherosclerosis.

机构信息

Division of Cardiology, Heart and Vascular Institute, Albert Einstein Medical Center, Philadelphia, Penn.

The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md.

出版信息

Am J Med. 2021 Apr;134(4):519-525. doi: 10.1016/j.amjmed.2020.09.023. Epub 2020 Dec 5.

DOI:10.1016/j.amjmed.2020.09.023

PMID:33285128

Abstract

BACKGROUND

The American Heart Association (AHA) has defined Life's Simple 7 (LS7) as a measure of overall cardiovascular health . Nonalcoholic fatty liver disease (NAFLD) has been involved as a risk factor for cardiovascular disease. We evaluated the association between LS7 and NAFLD.

METHODS

We evaluated participants form the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Cardiovascular health score was calculated from the Life's Simple 7 metrics. A score of 0-8 was considered inadequate, 9-10 average, and 11-14 optimal. NAFLD was defined using noncontrast cardiac computed tomography (CT) and a liver/spleen attenuation ratio (L/S) < 1. Multivariable regression were performed to evaluate the association.

RESULTS

Our cross-sectional analysis of 3901 participants showed 19% (n = 747) had optimal cardiovascular health, 33% (n = 1270) had average, and 48% (n = 1884) had inadequate. White participants were most likely to have an optimal score (51%, n = 378), whereas African American participants had the lowest proportion with optimal scores (16%, n = 120; P < 0.001). The overall prevalence of NAFLD was 18% with a distribution of 7%, 14%, and 25% in the optimal, average, and inadequate score categories, respectively (P < 0.001). Adjusted for risk factors, average and optimal health categories had lower odds of NAFLD compared to those with inadequate scores: odds ratio for average, 0.44 (95% confidence interval 0.36-0.54); optimal, odds ratio 0.19 (95% confidence interval 0.14-0.26). This association was similar across gender, race and age groups.

CONCLUSION

A more favorable cardiovascular health score was associated with a lower prevalence of NAFLD. This study may suggest a potential of Life's Simple 7 in the prevention of liver disease.

摘要

背景

美国心脏协会（AHA）将“生命的七大要素”（LS7）定义为衡量整体心血管健康的指标。非酒精性脂肪性肝病（NAFLD）已被认为是心血管疾病的一个危险因素。我们评估了 LS7 与 NAFLD 之间的关系。

方法

我们评估了来自多民族动脉粥样硬化研究（MESA）队列的参与者。心血管健康评分是根据“生命的七大要素”的指标计算得出的。评分 0-8 分为不足，9-10 分为平均，11-14 分为最佳。使用非对比心脏计算机断层扫描（CT）和肝脏/脾脏衰减比（L/S）<1 来定义 NAFLD。采用多变量回归来评估相关性。

结果

我们对 3901 名参与者的横断面分析显示，19%（n=747）具有最佳的心血管健康，33%（n=1270）具有平均水平，48%（n=1884）具有不足。白人参与者最有可能获得最佳评分（51%，n=378），而非洲裔美国参与者获得最佳评分的比例最低（16%，n=120；P<0.001）。NAFLD 的总体患病率为 18%，在最佳、平均和不足评分类别中，分别有 7%、14%和 25%的患者（P<0.001）。在调整了危险因素后，与评分不足者相比，健康状况处于平均和最佳水平者发生 NAFLD 的可能性较低：平均评分的比值比为 0.44（95%置信区间为 0.36-0.54）；最佳评分的比值比为 0.19（95%置信区间为 0.14-0.26）。这种相关性在性别、种族和年龄组中是相似的。