Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
Sci Rep. 2024 Oct 14;14(1):24024. doi: 10.1038/s41598-024-74841-3.
This investigation seeks to explore the correlation between nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs), and to to provide evidence for the prevention and treatment of CVDs.
This study utilized data from the Jinchang cohort platform, including 19,399 participants without pre-existing major CVDs. Based on the general population and gender stratification, Cox models were used to analyze the risk of NAFLD for CVDs. The combined effect of NAFLD and different obesity indicators on CVDs was analyzed by additive and multiplicative interaction models and subgroups.
There were 3129 NAFLD patients out of 19399 subjects, and 723 (23.11%) of them had the CVD. After adjusting for multiple confounding factors, the Cox model revealed a 1.17-fold increase in the risk of CVDs among patients with NAFLD compared to those without NAFLD. Moreover, there was no notable disparity in CVDs risk among most NAFLD patients at the same level of obesity. The results indicated no additive interaction between NAFLD and obesity concerning CVDs risk, but rather a positive multiplicative interaction. Using the normal population as a reference, it was found that people with both obesity and NAFLD significantly increased the risk of developing CVDs, with HRs and 95% CIs of 1.790 (1.508, 2.126), 1.356 (1.213, 1.517), and 1.807 (1.503, 2.174), respectively, for BMI, WC, and the combination of BMI and WC.
NAFLD and obesity are independent risk factors for CVDs. The synergy of obesity and NAFLD implies that NAFLD patients should control weight gain. Larger BMI and WC values may increase the CVDs risk for NAFLD patients, especially women.
本研究旨在探讨非酒精性脂肪性肝病（NAFLD）与心血管疾病（CVDs）之间的相关性，为 CVDs 的防治提供依据。
本研究利用金昌队列平台的数据，纳入 19399 例无既往重大 CVDs 的参与者。基于普通人群和性别分层，采用 Cox 模型分析 NAFLD 对 CVDs 的发病风险。采用加性和乘法交互模型及亚组分析，探讨 NAFLD 与不同肥胖指标对 CVDs 的联合作用。
19399 例受试者中，有 3129 例患有 NAFLD，其中 723 例（23.11%）患有 CVD。调整多个混杂因素后，Cox 模型显示，与无 NAFLD 者相比，NAFLD 患者 CVDs 的发病风险增加 1.17 倍。而且，大多数 NAFLD 患者在肥胖程度相同时，其 CVDs 发病风险无明显差异。结果表明，NAFLD 与肥胖对 CVDs 风险无明显的加性交互作用，而存在正的乘法交互作用。以普通人群为参照，发现肥胖且患有 NAFLD 的人群发生 CVDs 的风险显著增加，HR 值及其 95%CI 分别为 1.790（1.508，2.126）、1.356（1.213，1.517）和 1.807（1.503，2.174），分别对应 BMI、WC 及 BMI 和 WC 的组合。
NAFLD 和肥胖是 CVDs 的独立危险因素。肥胖和 NAFLD 的协同作用提示 NAFLD 患者应控制体重增加。更大的 BMI 和 WC 值可能会增加 NAFLD 患者的 CVDs 发病风险，尤其是女性。
