Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA.
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
Dig Dis Sci. 2021 Jun;66(6):2092-2100. doi: 10.1007/s10620-021-06954-y. Epub 2021 Mar 29.
Nonalcoholic fatty liver disease is common and is associated with rising morbidity and mortality in the UK. Cardiovascular disease is the main cause of death in people with nonalcoholic fatty liver disease.
To determine the association between baseline cardiovascular risk factors with fatty liver index, and to investigate the association between fatty liver index and the incidence of cardiovascular disease in the UK.
This study is a population-based retrospective cohort study using the UK Biobank database.
The mean fatty liver index in the study cohort was 44.9, and 33.7% met the criteria for nonalcoholic fatty liver disease. Fatty liver index was significantly associated with a wide range of cardiovascular risk factors at baseline. During a mean follow-up of 7.86 years, the combined incidence of cardiovascular disease was 6.92 per 1000-person years at risk. We found significant association between fatty liver index and incident cardiovascular disease in the fully adjusted model. We found significant association between fatty liver index and incident cardiovascular disease in subgroups stratified by BMI as well as subgroups with fatty liver index < 30, < 60, and ≥ 60.
Fatty liver index not only predicts NAFLD diagnosis, but also indicates baseline and future development of cardiovascular disease on long-term follow-up across weight categories and fatty liver index spectrum. These findings can inform clinicians and other stakeholders on cardiovascular disease management and preventive efforts. Patients with high fatty liver index should be counseled on the increased future risk of developing cardiovascular disease.
非酒精性脂肪性肝病在英国较为常见,其发病率和死亡率呈上升趋势。心血管疾病是非酒精性脂肪性肝病患者的主要死亡原因。
确定基线心血管危险因素与脂肪肝指数之间的关系,并探讨脂肪肝指数与英国心血管疾病发病率之间的关系。
本研究是一项基于人群的回顾性队列研究,使用英国生物银行数据库。
研究队列的平均脂肪肝指数为 44.9,33.7%符合非酒精性脂肪性肝病的标准。脂肪肝指数与基线时广泛的心血管危险因素显著相关。在平均 7.86 年的随访期间,风险人群中每 1000 人年的心血管疾病总发病率为 6.92 例。在完全调整的模型中,我们发现脂肪肝指数与心血管疾病的发生显著相关。在按 BMI 分层的亚组以及脂肪肝指数<30、<60 和≥60 的亚组中,我们均发现脂肪肝指数与心血管疾病的发生显著相关。
脂肪肝指数不仅可以预测非酒精性脂肪性肝病的诊断,还可以指示长期随访中不同体重类别和脂肪肝指数范围内的心血管疾病的基线和未来发展。这些发现可以为临床医生和其他利益相关者提供有关心血管疾病管理和预防工作的信息。脂肪肝指数较高的患者应接受有关未来发生心血管疾病风险增加的咨询。