Cardiometabolic Risk Unit, Institute of Clinical Physiology, National Research Council (CNR), Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, 40126 Bologna, Italy.
Int J Mol Sci. 2023 Sep 27;24(19):14651. doi: 10.3390/ijms241914651.
A fatty liver index (FLI) greater than sixty (FLI ≥ 60) is an established score for metabolic dysfunction-associated steatotic liver disease (MASLD), which carries a high risk for diabetes and cardiovascular disease, while a FLI ≤ 20 rules out the presence of steatosis. Thus, we investigated whether FLI was associated with cardiometabolic risk factors, i.e., visceral (VAT), subcutaneous (SC), epicardial (EPI), extrapericardial (PERI), and total cardiac (CARD-AT) adipose tissue, hepatic fat ((by magnetic resonance imaging, MRI, and spectroscopy, MRS), and insulin resistance (IR, HOMA-IR and OGIS-index), and components of metabolic syndrome. All individuals with FLI ≥ 60 had MASLD, while none with FLI ≤ 20 had steatosis (by MRS). Subjects with FLI ≥ 60 had a higher BMI and visceral and cardiac fat (VAT > 1.7 kg, CARD-AT > 0.2 kg). FLI was positively associated with increased cardiac and visceral fat and components of metabolic syndrome. FLI, VAT, and CARD-AT were all associated with IR, increased blood pressure, cholesterol, and reduced HDL. For FLI ≥ 60, the cut-off values for fat depots and laboratory measures were estimated. In conclusion, FLI ≥ 60 identified not only subjects with steatosis but also those with IR, abdominal and cardiac fat accumulation, increased blood pressure, and hyperlipidemia, i.e., those at higher risk of cardiometabolic diseases. Targeted reduction of FLI components would help reduce cardiometabolic risk.
脂肪性肝病指数（FLI）大于六十（FLI≥60）是代谢功能障碍相关脂肪性肝病（MASLD）的既定评分，它与糖尿病和心血管疾病的风险增加相关，而 FLI≤20 则排除了脂肪变性的存在。因此，我们研究了 FLI 是否与心血管代谢危险因素相关，即内脏（VAT）、皮下（SC）、心外膜（EPI）、心包外（PERI）和总心脏（CARD-AT）脂肪组织、肝脏脂肪（通过磁共振成像（MRI）和光谱学（MRS）测量）和胰岛素抵抗（HOMA-IR 和 OGIS 指数）以及代谢综合征的组成部分相关。所有 FLI≥60 的个体均患有 MASLD，而 FLI≤20 的个体均无脂肪变性（通过 MRS 测量）。FLI≥60 的受试者的 BMI 和内脏和心脏脂肪（VAT>1.7kg，CARD-AT>0.2kg）更高。FLI 与心脏和内脏脂肪以及代谢综合征的组成部分呈正相关。FLI、VAT 和 CARD-AT 均与 IR、血压升高、胆固醇升高和 HDL 降低相关。对于 FLI≥60，估计了脂肪储量和实验室测量的截止值。总之，FLI≥60 不仅可以识别出患有脂肪变性的患者，还可以识别出患有 IR、腹部和心脏脂肪堆积、血压升高和血脂异常的患者，即患有心血管代谢疾病风险更高的患者。有针对性地降低 FLI 成分将有助于降低心血管代谢风险。
