Liver fibrosis marker is an independent predictor of cardiovascular morbidity and mortality in the general population
Liver fibrosis marker is an independent predictor of cardiovascular morbidity and mortality in the general population
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DOI：
10.1016/j.dld.2020.10.014
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发表时间：
2021-01-01
影响因子：
4.5
通讯作者：
Zelber-Sagi, Shira
中科院分区：
文献类型：
--
作者：
Schonmann, Yochai;Yeshua, Hanny;Zelber-Sagi, Shira
背景：越来越多的证据表明非酒精性脂肪肝（NAFLD）和肝纤维化与心血管疾病（CVD）相关。然而，肝纤维化标志物在普通人群中预测 CVD 中的独立作用很少得到测试。 目的： 评估肝纤维化标志物是否可以预测社区普通人群大样本中 CVD 事件的首次发生。 方法： 使用来自运行集中计算机化医疗记录的大型医疗服务提供者的数据进行历史队列。肝纤维化水平通过纤维化-4 (FIB-4) 评分进行测量，并根据欧洲系统冠状动脉风险评估计算器 (SCORE) 调整与 CVD 的关联。 结果：该研究包括 8,511 名个体，其中 3,292 名患有不确定的纤维化，195 名患有晚期纤维化 (FIB-4 >= 2.67)。调整社会人口学特征、SCORE、他汀类药物和阿司匹林的使用后，晚期纤维化患者患 CVD 的风险较高（HR [95%CI]，1.63 [1.29-2.06]）。这种关联在女性和男性中都持续存在。使用年龄特异性截止值，不确定的晚期纤维化与 CVD 之间存在剂量反应相关性（HR [95%CI]，1.15 [1.01-1.31]）和 HR [95%CI]，1.60 [1.27-2.01]，P 代表趋势
Background: A growing body of evidence suggests that Non-alcoholic fatty liver disease (NAFLD) and liver fibrosis are associated with cardiovascular disease (CVD). However, the independent role of liver fibrosis markers in the prediction of CVD in the general population is seldom tested.Aims: To assess whether a marker of liver fibrosis predicts the first occurrence of a CVD event in a large sample of community-based general population.Methods: Historical cohort using data from a large health provider that operates a centralized computerized medical record. The level of liver fibrosis was measured by the fibrosis-4 (FIB-4) score, and the association with CVD was adjusted for the European Systematic Coronary Risk Evaluation calculator (SCORE).Results: The study included 8,511 individuals, 3,292 with inconclusive fibrosis and 195 with advanced fibrosis (FIB-4 >= 2.67). People with advanced fibrosis had higher risk for CVD, after adjustment for sociodemographic characteristics, the SCORE, use of statins and aspirin (HR [95%CI], 1.63 [1.29-2.06]). The association persisted in both women and men. Using age-specific cut-offs, there was a dose-response association between inconclusive and advanced fibrosis and CVD (HR [95%CI], 1.15 [1.01-1.31]) and HR [95%CI], 1.60 [1.27-2.01], respectively, P for trend