Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study
BackgroundThere have been no studies of the effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular events (CVEs) in patients with pre-diabetes (pre-DM), and diabetes mellitus (DM). We performed a community-based cohort study to evaluate the relationship between NAFLD and CVEs in patie...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.889597/full |
| _version_ | 1817991606840590336 |
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| author | Qi-Rui Song Shuo-Lin Liu Shuo-Lin Liu Ya-Guang Bi Ya-Guang Bi Shuo-Hua Chen Shou-Ling Wu Jun Cai |
| author_facet | Qi-Rui Song Shuo-Lin Liu Shuo-Lin Liu Ya-Guang Bi Ya-Guang Bi Shuo-Hua Chen Shou-Ling Wu Jun Cai |
| author_sort | Qi-Rui Song |
| collection | DOAJ |
| description | BackgroundThere have been no studies of the effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular events (CVEs) in patients with pre-diabetes (pre-DM), and diabetes mellitus (DM). We performed a community-based cohort study to evaluate the relationship between NAFLD and CVEs in patients with glucose metabolism disorder.MethodsWe enrolled 71,852 participants from the Kailuan study who had not experienced CVEs, after excluding alcohol abuse and other liver diseases. NAFLD was assessed using abdominal ultrasonography. Besides, participants were categorized by glucose metabolism status [normal glucose regulation (NGR), pre-DM, and DM]. All subjects were followed up for the occurrence of CVEs.ResultsDuring a median of 13.01 (0.64) years of follow-up, 6,037 CVEs occurred. NAFLD was present in 22,525 (31.3%), and compared with participants without NAFLD, those with NAFLD had a 12.3% [95% confidence interval (CI) 1.059–1.191, P < 0.001] higher risk of CVEs, after adjustment for potential confounders. The hazard ratios for patients with mild, moderate, and severe NAFLD were 1.104 (95% CI 1.035–1.179, P < 0.001), 1.149 (95% CI 1.055–1.251, P < 0.001), and 1.235 (95% CI 1.059–1.441, P < 0.001), respectively. Moreover, participants with pre-DM plus NAFLD and participants with DM plus NAFLD had 1.267-fold (95% CI 1.151–1.395, P < 0.001) and 1.829-fold (95% CI 1.666–2.008, P < 0.001) higher risks of CVEs, respectively, compared with those with NGR and no NAFLD. The addition of the combination of NAFLD and glucose metabolism status to the crude Cox model increased the C-statistic by 0.0066 (0.0053–0.0080, P < 0.001).ConclusionsNAFLD is associated with higher risks of CVEs. Moreover, NAFLD is an independent predictor of CVEs in patients with pre-DM and DM, suggesting that NAFLD may provide greater risk predictive value for patients with glucose metabolism disorder. |
| first_indexed | 2024-04-14T01:15:29Z |
| format | Article |
| id | doaj.art-f964a63ed41b419fb05c914189e96e63 |
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| language | English |
| last_indexed | 2024-04-14T01:15:29Z |
| publishDate | 2022-04-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-f964a63ed41b419fb05c914189e96e632022-12-22T02:20:54ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-04-01910.3389/fcvm.2022.889597889597Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort StudyQi-Rui Song0Shuo-Lin Liu1Shuo-Lin Liu2Ya-Guang Bi3Ya-Guang Bi4Shuo-Hua Chen5Shou-Ling Wu6Jun Cai7Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, ChinaShanghai Institute of Cardiovascular Diseases, Shanghai, ChinaDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, ChinaShanghai Institute of Cardiovascular Diseases, Shanghai, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaHypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundThere have been no studies of the effect of non-alcoholic fatty liver disease (NAFLD) on cardiovascular events (CVEs) in patients with pre-diabetes (pre-DM), and diabetes mellitus (DM). We performed a community-based cohort study to evaluate the relationship between NAFLD and CVEs in patients with glucose metabolism disorder.MethodsWe enrolled 71,852 participants from the Kailuan study who had not experienced CVEs, after excluding alcohol abuse and other liver diseases. NAFLD was assessed using abdominal ultrasonography. Besides, participants were categorized by glucose metabolism status [normal glucose regulation (NGR), pre-DM, and DM]. All subjects were followed up for the occurrence of CVEs.ResultsDuring a median of 13.01 (0.64) years of follow-up, 6,037 CVEs occurred. NAFLD was present in 22,525 (31.3%), and compared with participants without NAFLD, those with NAFLD had a 12.3% [95% confidence interval (CI) 1.059–1.191, P < 0.001] higher risk of CVEs, after adjustment for potential confounders. The hazard ratios for patients with mild, moderate, and severe NAFLD were 1.104 (95% CI 1.035–1.179, P < 0.001), 1.149 (95% CI 1.055–1.251, P < 0.001), and 1.235 (95% CI 1.059–1.441, P < 0.001), respectively. Moreover, participants with pre-DM plus NAFLD and participants with DM plus NAFLD had 1.267-fold (95% CI 1.151–1.395, P < 0.001) and 1.829-fold (95% CI 1.666–2.008, P < 0.001) higher risks of CVEs, respectively, compared with those with NGR and no NAFLD. The addition of the combination of NAFLD and glucose metabolism status to the crude Cox model increased the C-statistic by 0.0066 (0.0053–0.0080, P < 0.001).ConclusionsNAFLD is associated with higher risks of CVEs. Moreover, NAFLD is an independent predictor of CVEs in patients with pre-DM and DM, suggesting that NAFLD may provide greater risk predictive value for patients with glucose metabolism disorder.https://www.frontiersin.org/articles/10.3389/fcvm.2022.889597/fullnon-alcoholic fatty liver diseasecardiovascular diseasediabetes mellituscoronary artery diseaseprognosis |
| spellingShingle | Qi-Rui Song Shuo-Lin Liu Shuo-Lin Liu Ya-Guang Bi Ya-Guang Bi Shuo-Hua Chen Shou-Ling Wu Jun Cai Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study Frontiers in Cardiovascular Medicine non-alcoholic fatty liver disease cardiovascular disease diabetes mellitus coronary artery disease prognosis |
| title | Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study |
| title_full | Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study |
| title_fullStr | Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study |
| title_full_unstemmed | Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study |
| title_short | Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study |
| title_sort | non alcoholic fatty liver disease is associated with cardiovascular outcomes in subjects with prediabetes and diabetes a prospective community based cohort study |
| topic | non-alcoholic fatty liver disease cardiovascular disease diabetes mellitus coronary artery disease prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.889597/full |
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