Rong Fen, Mai Yiyi, Shou Lujia, Zhu Xinya, Li Meiyue, Zhu Liuchen, Sun Xiuli, Zhao Xinhua
School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Nutr. 2024 Nov 22;11:1502671. doi: 10.3389/fnut.2024.1502671. eCollection 2024.
Non-alcoholic Fatty Liver Disease (NAFLD) is a prevalent condition characterized by the accumulation of fat in the liver, often linked with increased risk for multi-systemic diseases. This study aims to investigate the relationship between NAFLD and mortality, particularly all-cause and cardiovascular mortality, among United States adults.
Data from the National Health and Nutrition Examination Survey (NHANES) were utilized, encompassing 80,312 participants from 2003-2004 to 2017-2018. After exclusions for incomplete data, potential other liver diseases, and significant alcohol consumption, the final analytical cohort included 32,698 participants. The Fatty Liver Index (FLI), a non-invasive diagnostic tool, was used to identify NAFLD. Covariates included demographic characteristics, lifestyle factors, and biochemical parameters. Survival analysis was conducted using a weighted Cox proportional hazards regression model to quantify the impact of NAFLD on mortality.
The study revealed that NAFLD was significantly associated with increased risks of all-cause and cardiovascular disease (CVD) mortality. The hazard ratios (HRs) from the survival analysis consistently indicated a higher risk among participants with NAFLD compared to those without. Subgroup analyses further confirmed the association, with notable exceptions in certain subgroups such as those with high school education and diabetes. Additionally, a nonlinear relationship between serum uric acid (SUA) levels and mortality risk was identified among NAFLD participants.
Non-alcoholic Fatty Liver Disease is a significant risk factor for all-cause and CVD mortality in US adults. The findings underscore the importance of early detection and intervention for NAFLD to mitigate its impact on public health. Further research is needed to explore the complex interactions between NAFLD, SUA levels, and mortality, particularly in high-risk subgroups.
非酒精性脂肪性肝病（NAFLD）是一种常见病症，其特征为肝脏中脂肪堆积，常与多系统疾病风险增加相关。本研究旨在调查美国成年人中NAFLD与死亡率之间的关系，尤其是全因死亡率和心血管疾病死亡率。
利用美国国家健康与营养检查调查（NHANES）的数据，涵盖了2003 - 2004年至2017 - 2018年的80312名参与者。在排除数据不完整、潜在的其他肝脏疾病以及大量饮酒情况后，最终分析队列包括32698名参与者。使用非侵入性诊断工具脂肪肝指数（FLI）来识别NAFLD。协变量包括人口统计学特征、生活方式因素和生化参数。采用加权Cox比例风险回归模型进行生存分析，以量化NAFLD对死亡率的影响。
研究表明，NAFLD与全因死亡率和心血管疾病（CVD）死亡率风险增加显著相关。生存分析得出的风险比（HRs）始终表明，患有NAFLD的参与者比未患NAFLD的参与者风险更高。亚组分析进一步证实了这种关联，但在某些亚组中存在显著例外，如高中学历者和糖尿病患者。此外，在NAFLD参与者中发现血清尿酸（SUA）水平与死亡风险之间存在非线性关系。
非酒精性脂肪性肝病是美国成年人全因死亡率和CVD死亡率的重要危险因素。这些发现强调了早期发现和干预NAFLD以减轻其对公众健康影响的重要性。需要进一步研究来探索NAFLD、SUA水平和死亡率之间的复杂相互作用，特别是在高危亚组中。
