The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study

<p><strong>Background:</strong> Lifestyle factors are associated with chronic liver disease (CLD) and death after CLD diagnosis. However, their associations with pathways of CLD progression have been unclear, particularly transition to cardiometabolic disease (CMD), a major comorbi...

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Main Authors: Pang, Y, Han, Y, Yu, C, Kartsonaki, C, Guo, Y, Chen, Y, Yang, L, Du, H, Hou, W, Schmidt, D, Stevens, R, Chen, J, Chen, Z, Lv, J, Li, L
Format: Journal article
Language:English
Published: Elsevier 2022
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author Pang, Y
Han, Y
Yu, C
Kartsonaki, C
Guo, Y
Chen, Y
Yang, L
Du, H
Hou, W
Schmidt, D
Stevens, R
Chen, J
Chen, Z
Lv, J
Li, L
author_facet Pang, Y
Han, Y
Yu, C
Kartsonaki, C
Guo, Y
Chen, Y
Yang, L
Du, H
Hou, W
Schmidt, D
Stevens, R
Chen, J
Chen, Z
Lv, J
Li, L
author_sort Pang, Y
collection OXFORD
description <p><strong>Background:</strong> Lifestyle factors are associated with chronic liver disease (CLD) and death after CLD diagnosis. However, their associations with pathways of CLD progression have been unclear, particularly transition to cardiometabolic disease (CMD), a major comorbid condition with CLD. We assessed the associations of lifestyle factors with CLD progression.</p> <p><strong>Methods:</strong> The study population involved 486,828 participants of the prospective China Kadoorie Biobank (CKB) aged 30-79 years without a history of cardiovascular disease, diabetes, CLD, or cancer at baseline. Liver-cardiometabolic comorbidity (LCC) was defined as developing CMD subsequently after first CLD (FCLD) in an individual. A multi-state model was used to estimate the associations of high-risk lifestyle factors (smoking, alcohol, physical inactivity, and central adiposity) with CLD progression from healthy to FCLD, subsequently to LCC, and further to death.</p> <p><strong>Findings:</strong> During a median follow-up of 11 years, 5046 participants developed FCLD, 519 developed LCC, and 157 died afterwards. There were positive associations between the number of high-risk lifestyle factors and risks of all transitions. The hazard ratios (95% CIs) per 1-factor increase were 1.30 (1.25-1.35) for transitions from baseline to FCLD, 1.21 (1.09-1.34) for FCLD to LCC, 1.20 (1.17-1.23) for baseline to death, 1.15 (1.09-1.22) for FCLD to death, and 1.17 (1.06-1.31) for LCC to death. For CLD subtypes, lifestyle factors showed different associations with disease-specific transitions even within the same transition stage.</p> <p><strong>Interpretation:</strong> High-risk lifestyle factors played a key role in all disease transition stages from healthy to FCLD, subsequently to LCC, and then to death, with different magnitude of associations.</p>
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spelling oxford-uuid:2a6a7f94-9163-46e6-9df6-ab50646512002022-10-13T08:43:07ZThe role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2a6a7f94-9163-46e6-9df6-ab5064651200EnglishSymplectic ElementsElsevier2022Pang, YHan, YYu, CKartsonaki, CGuo, YChen, YYang, LDu, HHou, WSchmidt, DStevens, RChen, JChen, ZLv, JLi, L<p><strong>Background:</strong> Lifestyle factors are associated with chronic liver disease (CLD) and death after CLD diagnosis. However, their associations with pathways of CLD progression have been unclear, particularly transition to cardiometabolic disease (CMD), a major comorbid condition with CLD. We assessed the associations of lifestyle factors with CLD progression.</p> <p><strong>Methods:</strong> The study population involved 486,828 participants of the prospective China Kadoorie Biobank (CKB) aged 30-79 years without a history of cardiovascular disease, diabetes, CLD, or cancer at baseline. Liver-cardiometabolic comorbidity (LCC) was defined as developing CMD subsequently after first CLD (FCLD) in an individual. A multi-state model was used to estimate the associations of high-risk lifestyle factors (smoking, alcohol, physical inactivity, and central adiposity) with CLD progression from healthy to FCLD, subsequently to LCC, and further to death.</p> <p><strong>Findings:</strong> During a median follow-up of 11 years, 5046 participants developed FCLD, 519 developed LCC, and 157 died afterwards. There were positive associations between the number of high-risk lifestyle factors and risks of all transitions. The hazard ratios (95% CIs) per 1-factor increase were 1.30 (1.25-1.35) for transitions from baseline to FCLD, 1.21 (1.09-1.34) for FCLD to LCC, 1.20 (1.17-1.23) for baseline to death, 1.15 (1.09-1.22) for FCLD to death, and 1.17 (1.06-1.31) for LCC to death. For CLD subtypes, lifestyle factors showed different associations with disease-specific transitions even within the same transition stage.</p> <p><strong>Interpretation:</strong> High-risk lifestyle factors played a key role in all disease transition stages from healthy to FCLD, subsequently to LCC, and then to death, with different magnitude of associations.</p>
spellingShingle Pang, Y
Han, Y
Yu, C
Kartsonaki, C
Guo, Y
Chen, Y
Yang, L
Du, H
Hou, W
Schmidt, D
Stevens, R
Chen, J
Chen, Z
Lv, J
Li, L
The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title_full The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title_fullStr The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title_full_unstemmed The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title_short The role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in Chinese population: a prospective cohort study
title_sort role of lifestyle factors on comorbidity of chronic liver disease and cardiometabolic disease in chinese population a prospective cohort study
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