今
日
推
荐
摘
要
背景
在澳大利亚,脂肪肝疾病(FLD)和心血管疾病(CVD)之间的关系尚未确定。本研究的主要目的是调查FLD和3点主要心血管不良事件(MACE)之间的关系。
方法
这是一项2001年至2003年间对澳大利亚地区随机抽样的成人队列的纵向随访研究。基线协变量包括人口统计学细节、人体测量、健康和生活方式数据以及实验室检查。非酒精性脂肪性肝病(NAFLD)和代谢-(功能障碍)相关的脂肪性肝病(MAFLD)在脂肪肝指数(FLI) ≥ 60且符合其他标准的参与者中被诊断。ICD-10编码用于定义与住院相关的临床结果。三点MACE定义为非致命性心肌梗死(MI)和脑血管意外(CVA)和CVD死亡。
结果
总共分别有1324名和1444名参与者符合NAFLD和MAFLD分析的入选标准。在超过23,577和25,469人年的随访中,NAFLD和MAFLD是3点MACE的独立预测因子,调整了人口统计学协变量和已知的心脏代谢风险因素,同时将非CVD死亡视为竞争事件(NAFLD:亚危险比[sHR] 1.56,95%可信区间[CI 1.12–2.19];MAFLD:相对危险度为1.51,95%可信区间为1.11–2.06)。几项敏感性分析的结果都是正确的。
结论
两种形式的的FLD都增加了独立于传统心脏代谢危险因素的CVD风险。
原
文
背景
The association between fatty liver disease (FLD) and cardiovascular disease (CVD) in an Australian context has yet to be defined. The primary aim of this study was to investigate the association between FLD and 3-point major adverse cardiovascular events (MACE).
方法
This was a longitudinal follow-up study of a randomly sampled adult cohort from regional Australia between 2001 and 2003. Baseline covariates included demographic details, anthropometry, health and lifestyle data, and laboratory tests. Non-alcoholic fatty liver disease (NAFLD) and metabolic-(dysfunction) associated fatty liver disease (MAFLD) were diagnosed in participants with fatty liver index (FLI) ≥ 60 and meeting other standard criteria. ICD-10 codes were used to define clinical outcomes linked to hospitalisations. Three-point MACE defined as non-fatal myocardial infarction (MI) and cerebrovascular accident (CVA) and CVD death.
结果
In total, 1324 and 1444 participants met inclusion criteria for NAFLD and MAFLD analysis, respectively. Over 23,577 and 25,469 person-years follow-up, NAFLD and MAFLD were independent predictors for 3-point MACE, adjusting for demographic covariates and known cardiometabolic risk factors, whilst considering non-CVD death as a competing event (NAFLD: sub-hazard ratio [sHR] 1.56, 95% confidence interval [CI 1.12–2.19]; MAFLD: sHR 1.51, 95% CI 1.11–2.06). The results held true on several sensitivity analyses.
结论
Both forms of FLD increase the risk for CVD independent of traditional cardiometabolic risk factors.
原文链接
Vaz, K., Kemp, W., Majeed, A.et al.NAFLD and MAFLD independently increase the risk of major adverse cardiovascular events (MACE): a 20-year longitudinal follow-up study from regional Australia.Hepatol Int18, 1135–1143 (2024).
专家介绍
王 明 伟
医学博士,副主任医师,硕士研究生导师,浙江省医坛新秀,杭州市心血管病研究所副所长,杭州市马拉松研究所副所长,建德市第一人民医院副院长,杭州师范大学附属医院科研部副主任,杭州市博士创新站负责人(临安区第四人民医院),杭州师范大学十佳研究生优良学风示范团队。擅长疑难心血管病,尤其是冠状动脉复杂、急性或慢性闭塞性病变的介入手术治疗。熟练开展急诊经皮冠状动脉球囊成形术、冠脉内超声术、主动脉内气囊反搏术、冠脉内血栓抽吸术,完成各类冠心病手术2000余例。主持各类课题8项,发表论文50余篇,专利5项,SCI收录30余篇。致力于脂肪肝心脏病学的研究和传播。任中国医药教育协会心血管内科专业委员会常务委员,浙江省医学会心血管病学分会青年委员,浙江省医学会科研管理分会委员,浙江省医学会临床试验和伦理分会委员。
门诊时间:
周六上午精英门诊(杭师大附院门诊楼六楼名医门诊)
胡思琪|编辑
王明伟|校对
杭州市心血管病研究所
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