Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
Nutr Metab Cardiovasc Dis. 2024 Dec;34(12):2623-2629. doi: 10.1016/j.numecd.2024.09.001. Epub 2024 Sep 12.
In patients with NAFLD, liver fibrosis increases liver-related complications, but there is controversy about the increase in CVD. Based on a prospective cohort study, this study investigated the risk of cardiovascular disease due to liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
This study analyzed KCPS-II prospective cohort that tracked 104,399 people who participated in health check-ups at 18 institutions nationwide from 2004 to 2013. If the fatty liver index was 30 or higher, it was defined as SLD, and participants were classified into No-SLD, MASLD, MetALD, ALD, and Cryptogenic SLD. Liver fibrosis was defined by the FIB-4 index, and the occurrence of cardiovascular disease according to SLD classification was analyzed using Cox proportional model regression analysis. Out study included a total of 6,942 participants (6.6%) had MASLD, 6,694 (6.4%) had MetALD, 4,751 (4.6%) had ALD, and 382 (0.3%) had Cryptogenic SLD. For the cases of FIB-4 index ≥1.3, the multivariable-adjusted HR (95% CI) of cardiovascular disease was 2.27 (1.87-2-76) in MASLD, 1.67 (1.30-2.10) in MetALD, and 2.56 (1.99-3.30) in ALD, but it was 0.78 (0.19-3.10) in Cryptogenic_SLD, which was not significant. The risk of cardiovascular disease according to the fibrosis stage classified by BARD also presented similar results.
This prospective cohort study of Korean patients with newly defined MASLD, MetALD, and ALD with FIB-4 ≥ 1.3 at high risk of developing cardiovascular disease.
在非酒精性脂肪性肝病 (NAFLD) 患者中，肝纤维化会增加肝脏相关并发症，但肝纤维化是否会增加心血管疾病 (CVD) 仍存在争议。本研究基于一项前瞻性队列研究，旨在探讨代谢相关脂肪性肝病 (MASLD) 患者肝纤维化导致心血管疾病的风险。
本研究分析了 KCPS-II 前瞻性队列，该队列跟踪了 2004 年至 2013 年期间来自全国 18 个机构的 104399 名参加健康检查者的情况。如果脂肪肝指数（FLI）为 30 或更高，则定义为 SLD，并将参与者分为非 SLD、MASLD、MetALD、ALD 和隐匿性 SLD。肝纤维化通过 FIB-4 指数定义，根据 SLD 分类分析心血管疾病的发生情况，采用 Cox 比例模型回归分析。我们的研究共纳入 6942 名（6.6%）患者患有 MASLD、6694 名（6.4%）患有 MetALD、4751 名（4.6%）患有 ALD 和 382 名（0.3%）患有隐匿性 SLD。对于 FIB-4 指数≥1.3 的病例，多变量调整后的心血管疾病 HR（95%CI）在 MASLD 中为 2.27（1.87-2.76），在 MetALD 中为 1.67（1.30-2.10），在 ALD 中为 2.56（1.99-3.30），但在隐匿性 SLD 中为 0.78（0.19-3.10），差异无统计学意义。根据 BARD 分类的纤维化分期进行心血管疾病风险评估也得出了类似的结果。
本研究对韩国 MASLD、MetALD 和 ALD 患者进行了前瞻性队列研究，这些患者的 FIB-4≥1.3，心血管疾病风险较高。
