Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Centre, Seoul, Republic of Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Diabetes Obes Metab. 2022 Mar;24(3):465-472. doi: 10.1111/dom.14597. Epub 2021 Dec 1.
To investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and cardiovascular events among a nationally representative sample of young adults in Korea.
This population-based cohort study from the Korean National Health Insurance Service included adults who were aged 20 to 39 years when they underwent a health examination between 2009 and 2012. NAFLD was defined as a fatty liver index (FLI) ≥60, and participants were divided into three groups according to FLI (<30, 30-59 and ≥60) to investigate the dose-dependent effect of FLI score. Among 5 324 410 participants, 9.8% had an FLI ≥60. There were 13 051 myocardial infarctions (MIs; 0.39%) and 8573 strokes (0.26%) during a median follow-up of 8.4 years. In multivariable analysis, NAFLD was associated with a higher risk of MI and stroke (hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.61-1.77 and HR 1.73, 95% CI 1.63-1.84, respectively). MI and stroke had dose-dependent relationships with FLI (HR 1.28 in participants with FLI 30-59 and 1.73 in those with FLI ≥60 for MI and HR 1.18 in participants with FLI 30-59 and 1.41 in those with FLI ≥60 for stroke, respectively).
Nonalcholic fatty liver disease was an independent predictor of MI and stroke in young adults. These results suggest that primary prevention of cardiovascular disease should be emphasized in young adults with NAFLD.
调查韩国全国代表性年轻成年人样本中，非酒精性脂肪性肝病（NAFLD）与心血管事件之间的关系。
这项基于人群的队列研究来自韩国国民健康保险服务，纳入了在 2009 年至 2012 年期间接受健康检查时年龄在 20 至 39 岁的成年人。NAFLD 定义为脂肪性肝病指数（FLI）≥60，根据 FLI（<30、30-59 和≥60）将参与者分为三组，以研究 FLI 评分的剂量依赖性效应。在 5324410 名参与者中，有 9.8%的人 FLI≥60。在中位随访 8.4 年期间，发生了 13051 例心肌梗死（MI；0.39%）和 8573 例中风（0.26%）。多变量分析显示，NAFLD 与 MI 和中风风险增加相关（危险比 [HR]1.69，95%置信区间 [CI]1.61-1.77 和 HR 1.73，95% CI 1.63-1.84）。MI 和中风与 FLI 呈剂量依赖性关系（FLI 为 30-59 的参与者 HR 为 1.28，FLI≥60 的参与者 HR 为 1.73，FLI 为 30-59 的参与者 HR 为 1.18，FLI≥60 的参与者 HR 为 1.41）。
非酒精性脂肪性肝病是年轻人 MI 和中风的独立预测因素。这些结果表明，应强调在患有 NAFLD 的年轻成年人中进行心血管疾病的一级预防。
