Risk of Cardiovascular Disease in Individuals With Nonobese Nonalcoholic Fatty Liver Disease.
Risk of Cardiovascular Disease in Individuals With Nonobese Nonalcoholic Fatty Liver Disease.
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DOI：
10.1002/hep4.1818
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发表时间：
2022-03
影响因子：
5.1
通讯作者：
Corey KE
中科院分区：
文献类型：
--
作者：
Arvind A;Henson JB;Osganian SA;Nath C;Steinhagen LM;Memel ZN;Donovan A;Balogun O;Chung RT;Simon TG;Corey KE
非酒精性脂肪肝（NAFLD）与肥胖和心血管疾病（CVD）独立相关。CVD是主要肥胖的NAFLD成人人群死亡的主要原因。NAFLD越来越多地见于瘦和超重的个体（即，不肥胖），但目前尚不清楚他们患心血管疾病的风险是否与患有非酒精性脂肪肝和肥胖的人相当。我们采用前瞻性NAFLD患者队列，比较了肥胖和非肥胖个体的CVD患病率和发病率。在排除其他慢性肝病病因后，通过活检或成像诊断NAFLD。Logistic回归分析用于比较肥胖状态下基线CVD的几率。考克斯比例风险回归用于评估肥胖作为CVD事件的预测因子，并确定肥胖和非肥胖受试者中CVD的预测因子。基线时，肥胖成人的CVD患病率高于非肥胖成人（12.0% vs. 5.0%，P = 0.02）。然而，在随访期间，肥胖并不能预测CVD事件（风险比[HR]，1.24; 95%置信区间[CI]，0.69 - 2.22）或其他代谢性疾病。当将体重指数作为连续变量并排除超重受试者后，结果是一致的。年龄（校正HR [aHR]，1.05; 95% CI，1.03 - 1.08）、吸烟（aHR，4.61; 95% CI，1.89 - 11.22）和低密度脂蛋白水平降低（aHR，0.98; 95% CI，0.96 - 1.00）分别独立预测整个队列中肥胖受试者和非肥胖受试者的CVD事件。结论：与NAFLD和肥胖患者相比，超重或偏瘦的NAFLD患者不能避免发生CVD，尽管CVD预测因子在这些人群之间存在差异。没有肥胖的患者也应该接受严格的风险分层和治疗。
Nonalcoholic fatty liver disease (NAFLD) is independently associated with obesity and cardiovascular disease (CVD). CVD is the primary cause of mortality in the predominantly obese population of adults with NAFLD. NAFLD is increasingly seen in individuals who are lean and overweight (i.e., nonobese), but it is unclear whether their risk of CVD is comparable to those with NAFLD and obesity. Using a prospective cohort of patients with NAFLD, we compared the prevalence and incidence of CVD in individuals with and without obesity. NAFLD was diagnosed by biopsy or imaging after excluding other chronic liver disease etiologies. Logistic regression was used to compare the odds of baseline CVD by obesity status. Cox proportional hazards regression was used to evaluate obesity as a predictor of incident CVD and to identify predictors of CVD in subjects with and without obesity. At baseline, adults with obesity had a higher prevalence of CVD compared to those without obesity (12.0% vs. 5.0%, P = 0.02). During follow‐up, however, obesity did not predict incident CVD (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.69‐2.22) or other metabolic diseases. Findings were consistent when considering body mass index as a continuous variable and after excluding subjects who were overweight. Age (adjusted HR [aHR], 1.05; 95% CI, 1.03‐1.08), smoking (aHR, 4.61; 95% CI, 1.89‐11.22), and decreased low‐density lipoprotein levels (aHR, 0.98; 95% CI, 0.96‐1.00) independently predicted incident CVD in the entire cohort, in subjects with obesity, and in those without obesity, respectively. Conclusion: Individuals with overweight or lean NAFLD are not protected from incident CVD compared to those with NAFLD and obesity, although CVD predictors appear to vary between these groups. Patients without obesity also should undergo rigorous risk stratification and treatment.
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肝脂肪变性与主要不良心血管事件的关联，与冠状动脉疾病无关。
DOI：
10.1016/j.cgh.2020.07.030
发表时间：
2021-07
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Meyersohn NM;Mayrhofer T;Corey KE;Bittner DO;Staziaki PV;Szilveszter B;Hallett T;Lu MT;Puchner SB;Simon TG;Foldyna B;Voora D;Ginsburg GS;Douglas PS;Hoffmann U;Ferencik M
通讯作者：
Ferencik M
影响因子：
24.5
作者：
Chang, Yoosoo;Ryu, Seungho;Byrne, Christopher D.
通讯作者：
Byrne, Christopher D.
影响因子：
7.6
作者：
Ampuero, Javier;Aller, Rocio;Romero-Gomez, Manuel
通讯作者：
Romero-Gomez, Manuel
非酒精性脂肪性肝病心血管疾病风险的早期预测因素：非肥胖患者与肥胖患者
影响因子：
3.1
作者：
Shao, Congxiang;Ye, Junzhao;Zhong, Bihui
通讯作者：
Zhong, Bihui
影响因子：
1.6
作者：
Yoshitaka H;Hamaguchi M;Kojima T;Fukuda T;Ohbora A;Fukui M
通讯作者：
Fukui M