Yu Huang, Zhang Tingyi, Liu Yankun, Wang Wang, Guan Ziyi, Li Ping
Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Front Med (Lausanne). 2025 Mar 12;12:1538654. doi: 10.3389/fmed.2025.1538654. eCollection 2025.
Cardiovascular health (CVH) has been associated with various systemic diseases. However, the relationship between CVH, as measured by Life's Essential 8 (LE8), and liver function markers in the general population remains poorly understood.
This study analyzed data from 21,156 participants (aged ≥ 20) from the NHANES 2005-2018 to investigate the associations between CVH and liver function markers [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin and AST/ALT ratio]. Linear regression models were used, along with a restricted cubic spline (RCS) to assess dose-response. Weighted quantile sum (WQS) regression and quantile g-computation (QGC) analyses were employed to evaluate the association between CVH and liver function markers.
Linear regression analysis showed that each 1-point increase in CVH score was significantly associated with decreased levels of liver enzymes [ALT: -0.200 U/L (95% CI: -0.223, -0.176), AST: -0.043 U/L (-0.062, -0.024), GGT: -0.453 U/L (-0.509, -0.397), ALP: -0.310 U/L (-0.340, -0.281)] and increased levels of albumin [0.040 g/dL (0.036, 0.045)] and AST/ALT ratio [0.0056 (0.0051, 0.0061)]. Notably, CVH score demonstrated non-linear dose-response relationships with ALT, ALP, and AST/ALT ratio. Age significantly modified these associations, while nicotine exposure, BMI, and blood lipids were identified as primary contributors through WQS and QGC analyses. E-value analysis suggested robustness to unmeasured confounding.
This study demonstrates robust associations between CVH and liver function markers in United States adults, with nicotine exposure, BMI, and blood lipids identified as significant contributors. These findings suggest that maintaining optimal cardiovascular health may have beneficial effects on liver function, highlighting potential targets for integrated prevention strategies.
心血管健康（CVH）与多种全身性疾病相关。然而，以生命必需的8项指标（LE8）衡量的CVH与一般人群肝功能指标之间的关系仍知之甚少。
本研究分析了2005 - 2018年美国国家健康与营养检查调查（NHANES）中21156名年龄≥20岁参与者的数据，以研究CVH与肝功能指标[丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）、白蛋白和AST/ALT比值]之间的关联。使用线性回归模型以及受限立方样条（RCS）来评估剂量反应。采用加权分位数和（WQS）回归和分位数g计算（QGC）分析来评估CVH与肝功能指标之间的关联。
线性回归分析表明，CVH评分每增加1分，与肝酶水平降低显著相关[ALT：-0.200 U/L（95%CI：-0.223，-0.176），AST：-0.043 U/L（-0.062，-0.024），GGT：-0.453 U/L（-0.509，-0.397），ALP：-0.310 U/L（-0.340，-0.281）]，与白蛋白水平升高[0.040 g/dL（0.036，0.045）]和AST/ALT比值升高[0.0056（0.0051，0.0061）]相关。值得注意的是，CVH评分与ALT、ALP和AST/ALT比值呈非线性剂量反应关系。年龄显著改变了这些关联，而通过WQS和QGC分析确定尼古丁暴露、体重指数（BMI）和血脂是主要影响因素。E值分析表明对未测量的混杂因素具有稳健性。
本研究表明在美国成年人中CVH与肝功能指标之间存在密切关联，尼古丁暴露、BMI和血脂被确定为重要影响因素。这些发现表明维持最佳心血管健康可能对肝功能有有益影响，突出了综合预防策略的潜在靶点。
