Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: a nationwide population-based study in Korea - PubMed (original) (raw)

Observational Study

Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: a nationwide population-based study in Korea

Jae-Hyung Roh et al. BMC Cardiovasc Disord. 2020.

Abstract

Background: Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals.

Methods: We analyzed the association between the FLI and new-onset HF with multivariate Cox proportional-hazards models in 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014.

Results: A total of 2532 subjects (0.8%) were newly diagnosed with HF during the study period (a median of 5.4 years). We categorized our subjects into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, > 31.0). The cumulative incidence of HF was significantly higher in the highest FLI group than in the lowest FLI group (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P < 0.001). Adjusted hazard ratio (HRs) indicated that the highest FLI group was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval = 2.380-3.085; P < 0.001). FLI was significantly associated with an increased risk of new-onset HF regardless of their baseline characteristics.

Conclusions: Higher FLI was independently associated with increased risk of HF in a healthy Korean population.

Keywords: Fatty liver index; Healthy people programs; Heart failure; Non-alcoholic fatty liver disease.

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Conflict of interest statement

Jae-Hyeong Park serves on the editorial boards as an associated editor of the BMC Cardiovascular Disorders. The other authors have nothing to declare.

Figures

Fig. 1

Fig. 1

Overview of the study population

Fig. 2

Fig. 2

Cumulative incidence of new onset heart failure according to their quartiles. Statistical significance was determined using the log-rank test

Fig. 3

Fig. 3

Forest plots of hazard ratios for new onset heart failure stratified by various clinical characteristics. CI = confidence interval; HR = hazard ratio

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