Association between liver fibrosis and incident dementia in the UK Biobank study.
Association between liver fibrosis and incident dementia in the UK Biobank study.
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DOI：
10.1111/ene.15437
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发表时间：
2022-09
影响因子：
5.1
通讯作者：
中科院分区：
文献类型：
--
作者：
人们越来越认识到慢性肝病会影响大脑健康。肝纤维化对痴呆风险的影响尚不清楚。我们在一项队列研究中评估了肝纤维化与痴呆发病率之间的关系。我们使用英国生物银行研究的数据进行了队列分析，该研究从2007年开始前瞻性招募成年人并继续随访。Fibrosis-4（FIB-4）肝纤维化评分>2.67的人被归类为晚期纤维化的高风险。主要结局是使用经验证的方法确定的痴呆事件。我们排除了基线时患有普遍痴呆症的参与者。我们使用考克斯比例风险模型来评估肝纤维化和痴呆之间的关系，同时调整潜在的混杂因素。在纳入本分析的455，226名参与者中，平均年龄为56.5岁，54%为女性。约2.17%（95% CI，2.13-2.22%）的患者发生肝纤维化。在患有肝纤维化的参与者中，每1,000人年的痴呆率为1.76（95%CI，1.50-2.07），而在没有肝纤维化的参与者中为0.52（95%CI，0.50-0.54）。在调整人口统计学、社会经济剥夺、教育程度、代谢综合征、高血压、糖尿病、血脂异常、吸烟和饮酒后，肝纤维化与痴呆风险增加相关（HR，1.52; 95%CI，1.22-1.90）。结果对敏感性分析具有稳健性。未观察到性别、代谢综合征和载脂蛋白E4携带状态对效应的影响。中年肝纤维化与痴呆发病风险增加相关，独立于共同的风险因素。肝纤维化可能是痴呆症的一个未被充分认识的危险因素。
There is growing recognition that chronic liver conditions influence brain health. The impact of liver fibrosis on dementia risk was unclear. We evaluated the association between liver fibrosis and incident dementia in a cohort study. We performed a cohort analysis using data from the UK Biobank study, which prospectively enrolled adults starting 2007 and continues to follow them. People with a Fibrosis-4 (FIB-4) liver fibrosis score >2.67 were categorized as high risk of advanced fibrosis. The primary outcome was incident dementia, ascertained using a validated approach. We excluded participants with prevalent dementia at baseline. We used Cox proportional hazards models to evaluate the association between liver fibrosis and dementia while adjusting for potential confounders. Among 455,226 participants included in this analysis, the mean age was 56.5 years and 54% were women. Approximately 2.17% (95% CI, 2.13–2.22%) had liver fibrosis. The rate of dementia per 1,000 person-years was 1.76 (95% CI, 1.50–2.07) in participants with liver fibrosis and 0.52 (95% CI, 0.50–0.54) in those without. After adjusting for demographics, socioeconomic deprivation, educational attainment, metabolic syndrome, hypertension, diabetes, dyslipidemia, and tobacco and alcohol use, liver fibrosis was associated with an increased risk of dementia (HR, 1.52; 95% CI, 1.22–1.90). Results were robust to sensitivity analyses. Effect modification by sex, metabolic syndrome, and apolipoprotein E4 carrier status was not observed. Liver fibrosis in middle age was associated with an increased risk of incident dementia, independent of shared risk factors. Liver fibrosis may be an underrecognized risk factor for dementia.
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影响因子：
11.2
作者：
Boyle PA;Yu L;Wilson RS;Leurgans SE;Schneider JA;Bennett DA
通讯作者：
Bennett DA
影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
影响因子：
64.8
作者：
Bycroft C;Freeman C;Petkova D;Band G;Elliott LT;Sharp K;Motyer A;Vukcevic D;Delaneau O;O'Connell J;Cortes A;Welsh S;Young A;Effingham M;McVean G;Leslie S;Allen N;Donnelly P;Marchini J
通讯作者：
Marchini J
影响因子：
11.1
作者：
Lumsden, Amanda L.;Mulugeta, Anwar;Hypponen, Elina
通讯作者：
Hypponen, Elina
影响因子：
3.8
作者：
Altamirano-Barrera, Alejandra;Barranco-Fragoso, Beatriz;Méndez-Sánchez, Nahum
通讯作者：
Méndez-Sánchez, Nahum