Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Med. 2024 Dec;56(1):2398724. doi: 10.1080/07853890.2024.2398724. Epub 2024 Sep 9.
To examine the associations of healthy lifestyles with risk of all-cause and cause-specific mortality among adults with metabolic dysfunction-associated steatotic liver disease (MASLD), and whether the association was mediated by systemic immune-inflammatory biomarkers (SIIBs).
The study included 10,347 subjects with MASLD, who were enrolled in the Dongfeng-Tongji cohort study. The healthy lifestyles referred to non-smoking, being physically active (≥7.5 metabolic equivalents-hours/week), low-risk alcohol consumption (1-14 g/day for women and 1-28 g/day for men), and optimal sleep duration (≥6 to ≤8 h/day). Cox proportional hazard models were used to examine the relationship between each lifestyle and SIIBs with the risk of all-cause and cause-specific mortality. A mediation analysis was conducted to investigate the role of SIIBs on the association between healthy lifestyles and mortality.
There were 418 MASLD subjects dead till the follow-up of 2018, including 259 deaths from cardiovascular disease (CVD). Compared to MASLD participants with 0-1 healthy lifestyle score (HLS), those with 3-4 HLS had the lowest risk of all-cause mortality [hazard ratio (HR), 0.46; 95% CI, (0.36-0.60)], and CVD mortality [HR (95%CI), 0.41 (0.29-0.58)]. Mediation analyses indicated that SIIBs mediated the association between healthy lifestyles and mortality, with proportions ranging from 2.5% to 6.1%.
These findings suggest that adherence to healthy lifestyles can significantly reduce mortality for MASLD patients, and the decreased SIIBs may partially explain the protection mechanism of healthy lifestyles.
探讨代谢相关脂肪性肝病（MASLD）患者健康生活方式与全因和特定原因死亡率的相关性，以及这种相关性是否由系统性免疫炎症生物标志物（SIIBs）介导。
该研究纳入了 10347 名 MASLD 患者，他们均来自东风-同济队列研究。健康生活方式包括不吸烟、身体活跃（每周≥7.5 代谢当量小时）、低风险饮酒（女性 1-14g/天，男性 1-28g/天）和最佳睡眠时间（6-8 小时/天）。采用 Cox 比例风险模型分析每种生活方式与 SIIBs 与全因和特定原因死亡率的关系。采用中介分析探讨 SIIBs 在健康生活方式与死亡率之间的关联中的作用。
在 2018 年的随访中，共有 418 名 MASLD 患者死亡，其中 259 人死于心血管疾病（CVD）。与健康生活方式评分（HLS）为 0-1 的 MASLD 患者相比，HLS 为 3-4 的患者全因死亡率最低[风险比（HR）为 0.46（95%CI，0.36-0.60）]，CVD 死亡率也最低[HR（95%CI）为 0.41（0.29-0.58）]。中介分析表明，SIIBs 介导了健康生活方式与死亡率之间的关联，其占比范围为 2.5%-6.1%。
这些发现表明，遵循健康的生活方式可以显著降低 MASLD 患者的死亡率，而 SIIBs 的降低可能部分解释了健康生活方式的保护机制。
