Sang Hyunji, Lim Jihye, Kim Ha Il
Department of Endocrinology and Metabolism, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
Dig Dis Sci. 2025 Jan;70(1):386-398. doi: 10.1007/s10620-024-08723-z. Epub 2024 Nov 29.
Steatotic liver disease (SLD) interacts with various comorbidities, impacting outcomes, yet little is known about the duration of comorbidities in SLD occurrence and mortality. We investigated this relationship, focusing on disease predictors and mortality rates.
Analyzing 2010 and 2015 Korea National Health and Nutrition Examination Survey data for patients aged ≥ 20, we categorized ten comorbidities (hypertension [HTN], diabetes mellitus [DM], dyslipidemia, stroke, myocardial infarction [MI], angina pectoris, asthma, chronic obstructive lung disease [COPD], chronic kidney disease [CKD], and depression) by duration. Association rule mining and logistic regression analyzed the association between SLD occurrence and comorbidity duration, while Cox regression assessed survival.
The analysis included 2,757 SLD and 9,505 non-SLD cases. Association rule mining showed that the shorter duration of DM and dyslipidemia and the longer duration of HTN comprised the top-ranked component for presence of SLD. DM with a duration ≤ 1 year showed higher risk of SLD than longer periods (odds ratio, 11.53), while the duration of cardiovascular disease, lung disease, or CKD was not significantly associated with the presence of SLD. In terms of prognosis, multivariate Cox regression showed that longer HTN and DM durations were significantly associated with increased hazard ratio (HR) beyond 10 years (HR, 2.22 and 2.11, respectively). Cardiovascular disease duration ≤ 5 years and lung disease duration > 5 years showed statistical significance (HR 2.49and 2.38, respectively).
Duration of comorbidities should be considered for comprehensive SLD risk stratification, for both the identification of SLD and the assessment of their prognosis after detection.
脂肪性肝病（SLD）与多种合并症相互作用，影响疾病转归，但对于合并症在SLD发生及死亡率中的持续时间知之甚少。我们研究了这种关系，重点关注疾病预测因素和死亡率。
分析2010年和2015年韩国国家健康与营养检查调查中年龄≥20岁患者的数据，我们按持续时间对十种合并症（高血压[HTN]、糖尿病[DM]、血脂异常、中风、心肌梗死[MI]、心绞痛、哮喘、慢性阻塞性肺疾病[COPD]、慢性肾脏病[CKD]和抑郁症）进行了分类。关联规则挖掘和逻辑回归分析了SLD发生与合并症持续时间之间的关联，而Cox回归评估了生存率。
分析纳入了2757例SLD病例和9505例非SLD病例。关联规则挖掘显示，DM和血脂异常持续时间较短以及HTN持续时间较长是SLD存在的排名靠前的组成部分。持续时间≤1年的DM发生SLD的风险高于较长时间（比值比，11.53），而心血管疾病、肺病或CKD的持续时间与SLD的存在无显著关联。在预后方面，多变量Cox回归显示，HTN和DM持续时间较长与超过10年的风险比（HR）增加显著相关（HR分别为2.22和2.11）。心血管疾病持续时间≤5年和肺病持续时间>5年具有统计学意义（HR分别为2.49和2.38）。
在对SLD进行全面的风险分层时，应考虑合并症的持续时间，这对于SLD的识别及其检测后的预后评估均有意义。
