Mori Kazuma, Tanaka Marenao, Higashiura Yukimura, Hanawa Nagisa, Ohnishi Hirofumi, Furuhashi Masato
Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan.
Hepatol Res. 2022 Aug;52(8):687-698. doi: 10.1111/hepr.13790. Epub 2022 Jun 1.
Fatty liver index (FLI), which is calculated by using body mass index, waist circumference and levels of γ-glutamyl transferase and triglycerides, is a validated surrogate marker of nonalcoholic fatty liver disease. We retrospectively investigated the relationship between FLI and the development of ischemic heart disease (IHD) during a 10-year period.
Among subjects who received annual health checkups (n = 28 990), a total of 18 851 subjects (men/women: 11 659/7192) were enrolled after exclusion of subjects with missing data and those with IHD at baseline.
FLI at baseline was significantly higher in men than in women. During the 10-year period, 450 men (3.9%) and 123 women (1.7%) had new onset of IHD determined by a self-reported questionnaire survey. Multivariable Cox proportional hazard models with a restricted cubic spline showed that hazard risk (HR) for the development of IHD increased with a higher FLI at baseline after adjustment of age, sex, current smoking habit, family history of IHD and diagnosis of diabetes mellitus, hypertension, dyslipidemia and chronic kidney disease at baseline. There was no significant interaction between FLI and sex for the adjusted HR. When divided by tertiles of FLI at baseline (T1∼T3), the adjusted risk for development of IHD in the T3 group (HR [95% confidence interval]: 1.34 [1.05-1.71]) was significantly higher than that in the T1 group as the reference. The addition of FLI into traditional risk factors for IHD significantly improved the discriminatory capability.
A high level of FLI is an independent predictor of new onset of IHD during a 10-year period.
通过体重指数、腰围、γ-谷氨酰转移酶水平和甘油三酯计算得出的脂肪肝指数(FLI)是已得到验证的非酒精性脂肪性肝病替代标志物。我们回顾性研究了10年间FLI与缺血性心脏病(IHD)发生之间的关系。
在接受年度健康检查的受试者(n = 28990)中,排除数据缺失和基线时患有IHD的受试者后,共纳入18851名受试者(男性/女性:11659/7192)。
男性基线时的FLI显著高于女性。在这10年期间,通过自我报告问卷调查确定有450名男性(3.9%)和123名女性(1.7%)新发IHD。采用受限立方样条的多变量Cox比例风险模型显示,在调整年龄、性别、当前吸烟习惯、IHD家族史以及基线时糖尿病、高血压、血脂异常和慢性肾脏病的诊断后,基线时FLI越高,IHD发生的风险(HR)越高。调整后的HR在FLI和性别之间无显著交互作用。按基线时FLI三分位数(T1∼T3)划分时,T3组IHD发生的调整风险(HR [95%置信区间]:1.34 [1.05 - 1.71])显著高于作为对照的T1组。将FLI纳入IHD传统危险因素后显著提高了鉴别能力。
高水平FLI是10年间IHD新发的独立预测因素。