Miao Ying, Wang Yu, Yan Pijun, Li Yi, Chen Zhuang, Tong Nanwei, Wan Qin
Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China.
Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Endocrinol (Lausanne). 2024 Dec 20;15:1367853. doi: 10.3389/fendo.2024.1367853. eCollection 2024.
The debate persists regarding whether metabolic dysfunction-associated steatotic liver disease (MASLD) actively contributes to coronary heart disease or merely acts as a passive indicator.
This research aims to clarify the relationship between liver fat accumulation, as quantified by FLI, and the risk of developing coronary heart disease.
Conducted from April to November 2011, the REACTION project, spearheaded by the Endocrinology Branch of the Chinese Medical Association, focused on Chinese adults aged 40 and above. Comprehensive data collection employed both questionnaires and specialized medical equipment, covering physical measurements, blood pressure, and pertinent biochemical markers. The study population excluded those with pre-existing coronary heart disease and acute myocardial infarction. Based on the initial data, participants were segmented and grouped into three categories. Analytically, the study utilized Cox proportional hazards models, further enhanced by stratified analyses to identify variations within predefined demographic groups.
In this study, we enrolled 8,647 participants, comprising 2,887 males and 5,760 females. Over the 10-year non-interventional follow-up period, 433 participants (5%) passed away due to various reasons, with 55 deaths attributed to coronary heart disease/myocardial infarction, accounting for 12.7% of total deaths. Additionally, 484 participants were diagnosed with new-onset coronary heart disease, resulting in an incidence rate of 5.5%. Spearman correlation analysis revealed a positive correlation between FLI and traditional risk factors for coronary heart disease, including age, male gender, abnormal glucose metabolism, hypertension, smoking, TG, TC, LDL-C, etc. The Log-rank test indicated a rising cumulative incidence of coronary heart disease with increasing FLI groupings (P<0.01). Moreover, Cox regression analysis highlighted a notable correlation between FLI levels as a risk factor and the onset of coronary heart disease. After adjusting for other risk factors, individuals in the 30≤FLI<60 group exhibited a 1.203-fold higher risk of coronary heart disease compared to those in the FLI<30 group (p=0.126), while participants in the FLI≥60 group had a 1.386-fold higher risk than those in the FLI<30 group (p=0.041).
Elevated FLI values are strongly associated with an increased susceptibility to coronary heart disease, indicating its potential value as a prognostic marker for the condition.
关于代谢功能障碍相关脂肪性肝病（MASLD）是积极促成冠心病还是仅仅作为一个被动指标，争论仍在继续。
本研究旨在阐明通过脂肪酸指数（FLI）量化的肝脏脂肪堆积与冠心病发病风险之间的关系。
由中华医学会内分泌学分会牵头的REACTION项目于2011年4月至11月开展，聚焦于40岁及以上的中国成年人。综合数据收集采用问卷调查和专业医疗设备，涵盖身体测量、血压及相关生化指标。研究人群排除了已患冠心病和急性心肌梗死的患者。根据初始数据，将参与者进行分层并分为三类。在分析方面，该研究采用Cox比例风险模型，并通过分层分析进一步强化，以识别预定义人口统计学组内的差异。
本研究纳入了8647名参与者，其中男性2887名，女性5760名。在10年的非干预随访期内，433名参与者（5%）因各种原因死亡，其中55例死于冠心病/心肌梗死，占总死亡人数的12.7%。此外，484名参与者被诊断为新发冠心病，发病率为5.5%。Spearman相关性分析显示，FLI与冠心病的传统风险因素之间存在正相关，包括年龄、男性、糖代谢异常、高血压、吸烟、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）等。Log-rank检验表明，随着FLI分组增加，冠心病的累积发病率上升（P<0.01）。此外，Cox回归分析强调FLI水平作为一个风险因素与冠心病发病之间存在显著相关性。在调整其他风险因素后，FLI在30≤FLI<60组的个体患冠心病的风险比FLI<30组的个体高1.203倍（p=0.126），而FLI≥60组的参与者比FLI<30组的个体患冠心病的风险高1.386倍（p=0.041）。
FLI值升高与冠心病易感性增加密切相关，表明其作为该疾病预后标志物的潜在价值。
