Gu Xinsheng, Gao Di, Zhou Xinjian, Ding Yueyou, Shi Wenrui, Park Jieun, Wu Shaohui, He Yue
Department of Cardiology, Shanghai Eighth People's Hospital, Shanghai, China.
Department of Intensive Care Unit, Shanghai Eighth People's Hospital, Shanghai, China.
Front Cardiovasc Med. 2024 Sep 5;11:1433807. doi: 10.3389/fcvm.2024.1433807. eCollection 2024.
Metabolic dysfunction associated steatotic liver disease (MASLD) contributes to the cardiometabolic diseases through multiple mechanisms. Fatty liver index (FLI) has been formulated as a non-invasive, convenient, and cost-effective approach to estimate the degree of MASLD. The current study aims to evaluate the correlation between FLI and the prevalent cardiometabolic multimorbidity (CMM), and to assess the usefulness of FLI to improve the detection of the prevalent CMM in the general population.
26,269 subjects were enrolled from the National Health and Nutrition Examination Survey 1999-2018. FLI was formulated based on triglycerides, body mass index, γ -glutamyltransferase, and waist circumference. CMM was defined as a history of 2 or more of diabetes mellitus, stroke, myocardial infarction.
The prevalence of CMM was 10.84%. With adjustment of demographic, anthropometric, laboratory, and medical history covariates, each standard deviation of FLI leaded to a 58.8% risk increase for the prevalent CMM. The fourth quartile of FLI had a 2.424 times risk for the prevalent CMM than the first quartile, and a trend towards higher risk was observed. Smooth curve fitting showed that the risk for prevalent CMM increased proportionally along with the elevation of FLI. Subgroup analysis demonstrated that the correlation was robust in several conventional subpopulations. Receiver-operating characteristic curve analysis revealed an incremental value of FLI for detecting prevalent CMM when adding it to conventional cardiometabolic risk factors (Area under the curve: 0.920 vs. 0.983, < 0.001). Results from reclassification analysis confirmed the improvement from FLI.
Our study demonstrated a positive, linear, and robust correlation between FLI and the prevalent CMM, and our findings implicate the potential usefulness of FLI to improve the detection of prevalent CMM in the general population.
代谢功能障碍相关脂肪性肝病（MASLD）通过多种机制导致心脏代谢疾病。脂肪肝指数（FLI）已被制定为一种无创、便捷且经济高效的方法来评估MASLD的程度。本研究旨在评估FLI与普遍存在的心脏代谢多重疾病（CMM）之间的相关性，并评估FLI在改善普通人群中普遍存在的CMM检测方面的有用性。
从1999 - 2018年国家健康与营养检查调查中纳入了26,269名受试者。FLI是基于甘油三酯、体重指数、γ-谷氨酰转移酶和腰围制定的。CMM被定义为有2种或更多糖尿病、中风、心肌梗死病史。
CMM的患病率为10.84%。在调整了人口统计学、人体测量学、实验室和病史协变量后，FLI每增加一个标准差，普遍存在的CMM风险增加58.8%。FLI的第四个四分位数患普遍存在的CMM的风险是第一个四分位数的2.424倍，且观察到风险有升高趋势。平滑曲线拟合显示，普遍存在的CMM风险随着FLI的升高而成比例增加。亚组分析表明，这种相关性在几个传统亚组中很强。受试者工作特征曲线分析显示，将FLI添加到传统心脏代谢危险因素中时，其在检测普遍存在的CMM方面具有增量价值（曲线下面积：0.920对0.983，P < 0.001）。重新分类分析结果证实了FLI的改善作用。
我们的研究表明FLI与普遍存在的CMM之间存在正相关、线性且很强的相关性，我们的发现表明FLI在改善普通人群中普遍存在的CMM检测方面具有潜在有用性。
