Nonoverweight nonalcoholic fatty liver disease and incident cardiovascular disease: A post hoc analysis of a cohort study.
Nonoverweight nonalcoholic fatty liver disease and incident cardiovascular disease: A post hoc analysis of a cohort study.
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DOI：
10.1097/md.0000000000006712
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发表时间：
2017-05
期刊：
影响因子：
1.6
通讯作者：
Fukui M
中科院分区：
文献类型：
--
作者：
Yoshitaka H;Hamaguchi M;Kojima T;Fukuda T;Ohbora A;Fukui M
非酒精性脂肪性肝病(NAFLD)被认为是心血管疾病(CVD)的危险因素。大约20%的NAFLD发生在非肥胖者身上。然而，非超重非酒精性脂肪肝与心血管疾病风险之间的关系仍有待阐明。因此，我们调查了非超重非酒精性脂肪肝与心血管事件的风险。我们对先前的前瞻性队列研究进行了事后分析，1647名日本人参加了研究。应用腹部超声诊断NAFLD。超重定义为世界卫生组织推荐的体重指数≥23 kg/m2。我们根据NAFLD的存在和/或超重将受试者分为4种表型。在调整了基线检查时的年龄、性别、吸烟状况、运动、高血压、高血糖、高甘油三酯血症和低高密度脂蛋白胆固醇后，用COX风险模型计算了4种表型对心血管事件的危险风险。非超重非酒精性脂肪肝患者心血管疾病的发生率为0.6%，非超重非酒精性脂肪肝患者为8.8%，超重非酒精性脂肪肝患者为1.8%，超重酒精性脂肪肝患者为3.3%。与非超重非酒精性脂肪肝相比，非超重非酒精性脂肪肝、超重非酒精性脂肪肝和超重非酒精性脂肪肝发生心血管事件的危险比分别为10.4(95%可信区间2.61~44.0，P = .001)、1.96(0.54~7.88，P = .31)和3.14(0.84~13.2，P = .09)。伴有NAFLD的非超重患者发生心血管疾病的风险较高。我们应该注意NAFLD，即使是非超重的个体，以防止进一步的CVD事件。
Nonalcoholic fatty liver disease (NAFLD) is known as a risk of incident cardiovascular disease (CVD). About 20% of NAFLD occurs in nonobese individuals. However, it remains to be elucidated the association between nonoverweight with NAFLD and a risk of incident CVD. Therefore, we investigated the risk of nonoverweight with NAFLD for incident CVD. We performed a post-hoc analysis of the previous prospective cohort study, in which 1647 Japanese were enrolled. Abdominal ultrasonography was used to diagnose NAFLD. Overweight was defined as body mass index ≥23 kg/m2, which is recommended by World Health Organization for Asian. We divided participants into 4 phenotypes by existence of NAFLD and/or overweight. The hazard risks of the 4 phenotypes for incident CVD were calculated by Cox hazard model after adjusting for age, sex, smoking status, exercise, hypertension, hyperglycemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol at baseline examination. Incident proportions of CVD were 0.6% in nonoverweight without NAFLD, 8.8% in nonoverweight with NAFLD, 1.8% in overweight without NAFLD, and 3.3% in overweight with NAFLD. Compared with nonoverweight without NAFLD, the adjusted hazard ratios of incident CVD were 10.4 (95% confidence interval 2.61–44.0, P = .001) in nonoverweight with NAFLD, 1.96 (0.54–7.88, P = .31) in overweight without NAFLD, and 3.14 (0.84–13.2, P = .09) in overweight with NAFLD. Nonoverweight with NAFLD was associated with higher risk of incident CVD. We should pay attention to NAFLD, even in nonoverweight individuals, to prevent further CVD events.