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

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 2,532 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.

Diagnostic ability using fatty liver and metabolic markers for metabolic‐associated fatty liver disease stratified by metabolic/glycemic abnormalities

“…This result can be attributed to the following. First, considering that fatty liver index can predict cardiovascular diseases 41 and that patients with MAFLD are more likely to develop these conditions, 3,4 FLI is presumably more effective in predicting MAFLD than in predicting NAFLD. Second, both markers have predictive ability for metabolic abnormalities, especially for glucose intolerance.…”

Nonalcoholic Fatty Liver Disease and Cardiac Remodeling Risk: Pathophysiological Mechanisms and Clinical Implications

“…Additionally, ultrasound-diagnosed NAFLD and its advanced fibrosis are associated with an increased risk of allcause mortality among older individuals with acute HF. (25)…”

Non-alcoholic fatty liver disease and risk of new-onset heart failure: an updated meta-analysis of about 11 million individuals

“…Figure 1 shows the results of the literature research and study selection. Based on the titles and abstracts of 490 selected citations (after excluding duplicates), we initially identified 17 potentially eligible studies from PubMed, Scopus or Web of Science databases prior to 21 March 2022 15–31. In online supplemental table 1, the syntax used and the records identified through database searches are presented.…”