Fatty Liver Index and Development of Cardiovascular Disease: Findings from the UK Biobank (original) (raw)

Abstract

Background

Nonalcoholic fatty liver disease is common and is associated with rising morbidity and mortality in the UK. Cardiovascular disease is the main cause of death in people with nonalcoholic fatty liver disease.

Aims

To determine the association between baseline cardiovascular risk factors with fatty liver index, and to investigate the association between fatty liver index and the incidence of cardiovascular disease in the UK.

Methods

This study is a population-based retrospective cohort study using the UK Biobank database.

Results

The mean fatty liver index in the study cohort was 44.9, and 33.7% met the criteria for nonalcoholic fatty liver disease. Fatty liver index was significantly associated with a wide range of cardiovascular risk factors at baseline. During a mean follow-up of 7.86 years, the combined incidence of cardiovascular disease was 6.92 per 1000-person years at risk. We found significant association between fatty liver index and incident cardiovascular disease in the fully adjusted model. We found significant association between fatty liver index and incident cardiovascular disease in subgroups stratified by BMI as well as subgroups with fatty liver index < 30, < 60, and ≥ 60.

Conclusions

Fatty liver index not only predicts NAFLD diagnosis, but also indicates baseline and future development of cardiovascular disease on long-term follow-up across weight categories and fatty liver index spectrum. These findings can inform clinicians and other stakeholders on cardiovascular disease management and preventive efforts. Patients with high fatty liver index should be counseled on the increased future risk of developing cardiovascular disease.

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Abbreviations

aHR:

Adjusted hazard ratios

BMI:

Body mass index

CVD:

Cardiovascular disease

CHD:

Coronary heart disease

DBP:

Diastolic blood pressure

FLI:

Fatty liver index

GGT:

Gamma-glutamyl transferase

HDL:

High-density lipoprotein

HES:

Hospital episode statistics

NAFLD:

Nonalcoholic fatty liver disease

SBP:

Systolic blood pressure

UK:

United Kingdom

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA
    Biyao Zou, Yee Hui Yeo, Ramsey Cheung & Mindie H. Nguyen
  2. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
    Biyao Zou
  3. Cedars Sinai Medical Center, Los Angeles, CA, USA
    Yee Hui Yeo
  4. Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Palo Alto, CA, USA
    Ramsey Cheung
  5. Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
    Erik Ingelsson
  6. Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA
    Erik Ingelsson
  7. Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA
    Erik Ingelsson

Authors

  1. Biyao Zou
  2. Yee Hui Yeo
  3. Ramsey Cheung
  4. Erik Ingelsson
  5. Mindie H. Nguyen

Contributions

Biyao Zou, Yee Hui Yeo, Erik Ingelsson and Mindie Nguyen contributed to study design. Biyao Zou contributed to data collection. Biyao Zou, Yee Hui Yeo, Erik Ingelsson and Mindie Nguyen contributed to data analysis. Biyao Zou and Mindie Nguyen contributed to drafting of the manuscript. All authors contributed to data interpretation and review/critical revision of the manuscript. Mindie Nguyen and Erik Ingelsson contributed to study concept and supervision.

Corresponding author

Correspondence toMindie H. Nguyen.

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Conflict of interest

Ramsey Cheung received research support from Gilead. Erik Ingelsson is now an employee at GlaxoSmithKline. Mindie Nguyen received research support from Pfizer and Gilead and is on the advisory board/consulting for Intercept and Gilead. Other authors have none to disclose.

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Zou, B., Yeo, Y.H., Cheung, R. et al. Fatty Liver Index and Development of Cardiovascular Disease: Findings from the UK Biobank.Dig Dis Sci 66, 2092–2100 (2021). https://doi.org/10.1007/s10620-021-06954-y

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