Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study

Song, Qirui; Liu, Shuo-Lin; Bi, Yaguang; Chen, Shuohua; Wu, Shouling; Cai, Jun

doi:10.3389/fcvm.2022.889597

Cited by 8 publications

(8 citation statements)

References 42 publications

(47 reference statements)

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“…However our study differs from these recent studies in several important ways. Several studies have examined this association in population in countries other than the United States ( Song et al, 2022a ; Song et al, 2022b ; Kolluru et al, 2022 ; Succurro et al, 2022 ; Xu et al, 2022 ). While informative, the results of these studies cannot be generalized to the United States population, and typically do not allow for examination by race/ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Shaheen

Schrode²,

Tedlos³

et al. 2023

Front. Physiol.

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Aim: Non-alcoholic fatty liver disease (NAFLD) exhibits a racial disparity. We examined the prevalence and the association between race, gender, and NAFLD among prediabetes and diabetes populations among adults in the United States.Methods: We analyzed data for 3,190 individuals ≥18 years old from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. NAFLD was diagnosed by FibroScan® using controlled attenuation parameter (CAP) values: S0 (none) < 238, S1 (mild) = 238–259, S2 (moderate) = 260–290, S3 (severe) > 290. Data were analyzed using Chi-square test and multinomial logistic regression, adjusting for confounding variables and considering the design and sample weights.Results: Of the 3,190 subjects, the prevalence of NAFLD was 82.6%, 56.4%, and 30.5% (p < 0.0001) among diabetes, prediabetes and normoglycemia populations respectively. Mexican American males with prediabetes or diabetes had the highest prevalence of severe NAFLD relative to other racial/ethnic groups (p < 0.05). In the adjusted model, among the total, prediabetes, and diabetes populations, a one unit increase in HbA1c was associated with higher odds of severe NAFLD [adjusted odds ratio (AOR) = 1.8, 95% confidence level (CI) = 1.4–2.3, p < 0.0001; AOR = 2.2, 95% CI = 1.1–4.4, p = 0.033; and AOR = 1.5, 95% CI = 1.1–1.9, p = 0.003 respectively].Conclusion: We found that prediabetes and diabetes populations had a high prevalence and higher odds of NAFLD relative to the normoglycemic population and HbA1c is an independent predictor of NAFLD severity in prediabetes and diabetes populations. Healthcare providers should screen prediabetes and diabetes populations for early detection of NAFLD and initiate treatments including lifestyle modification to prevent the progression to non-alcoholic steatohepatitis or liver cancer.

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Section: Discussionmentioning

confidence: 99%

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Shaheen

Schrode²,

Tedlos³

et al. 2023

Front. Physiol.

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“…[1][2][3][4]6 Growing evidence indicates that patients with NAFLD are at increased risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. [38][39][40][41] While lifestyle modifications remain the cornerstone of the management of NAFLD, 42 there has been a marked absence of effective pharmacological therapies approved for this condition. 43 Therefore, identifying emerging serum markers for NAFLD might help find high-risk individuals and develop auxiliary prevention or treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Plasma Aldosterone Concentrations and Non-Alcoholic Fatty Liver Disease Diagnosis in Patients with Hypertension: A Retrospective Cohort Study

Hu¹,

Cai²,

Zhu³

et al. 2023

DMSO

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Objective To investigate the association between plasma aldosterone concentration (PAC) and non-alcoholic fatty liver disease (NAFLD) diagnosis in Chinese hypertensive patients. Methods We conducted a retrospective study of all patients diagnosed with hypertension between January 1, 2010, and December 31, 2021. We included 3713 hypertensive patients based on the criteria for inclusion and exclusion. PAC measurement was performed using a radioimmunoassay. NAFLD was diagnosed using abdominal ultrasonography. Cox regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for univariable and multivariable models. A generalized additive model was used to identify nonlinear relationships between PAC and NAFLD diagnosis. Results A total of 3713 participants were included in the analysis. Over a median follow-up of 30 months, 1572 hypertensive individuals developed new-onset NAFLD. When PAC was used as a continuous variable, the risk of NAFLD increased by 1.04 and 1.24-fold for each 1 ng/dL and 5 ng/dL increase in PAC, respectively. When PAC was considered a categorical variable, the HR for tertile 3 was 1.71 (95% CI, 1.47–1.98, P < 0.001) compared to tertile 1. Overall, there was a J-shaped relationship between PAC and new-onset NAFLD. By fitting a two-piecewise linear regression model and using a recursive algorithm, we identified a PAC inflection point at 13 ng/dL (log-likelihood ratio test, P = 0.005). In adjusted model 3, for PAC ≥ 13 ng/dL, a 5 ng/dL increase in PAC was associated with a 30% increase in the risk of new-onset NAFLD (95% CI, 1.25–1.35, P < 0.001). Conclusion The study revealed a non-linear relationship between elevated PAC levels and the incidence of NAFLD in hypertensive patients. Notably, the risk of new-onset NAFLD was significantly increased when PAC levels were ≥13 ng/dL. Larger, prospective studies are necessary to confirm these findings.

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“…CVE was defined previously [ 28 ] as a composite of stroke and MI until December 31, 2019 [ 29 ]. The endpoints of this study were the first appearance of CVE, which was identified by medical staff from the provincial vital statistics data, Tangshan medical insurance system, and Kailuan Group Medical Insurance Information System during the semiannual interviews.…”

Section: Methodsmentioning

confidence: 99%

“…The concentrations of the lipid parameters were determined using an automatic biochemistry analyzer (Hitachi 747, Tokyo, Japan) [ 28 ]. White blood cell counts were measured using an XE-1200 automated hematology analyzer (Sysmex, Kobe, Japan).…”

Section: Methodsmentioning

confidence: 99%

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Neutrophil to high-density lipoprotein cholesterol ratio predicts adverse cardiovascular outcomes in subjects with pre-diabetes: a large cohort study from China

et al. 2022

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Background This study aimed to examine whether the neutrophil to high-density lipoprotein cholesterol ratio (NHR) can predict cardiovascular outcomes in normoglycemic individuals with elevated fasting glucose levels. Methods A total of 130,801 participants with normal blood glucose levels were enrolled in the Kailuan study. Participants were categorized according to NHR quartiles and further divided into normal glucose regulation (NGR) and pre-diabetes (pre-DM) subgroups. The follow-up endpoint was major adverse cardiovascular events (CVE), including stroke and myocardial infarction. Results Over a median of 12.53 (8.95–13.08) years of follow-up, subjects with NHR levels in the highest quartile experienced more CVE than those with NHR levels in the lowest quartile. Multivariate Cox analyses showed that continuous changes in NHR (hazard ratio, 1.21; 95% confidence interval [CI], 1.15–1.28) and the highest quartile of NHR (hazard ratio, 1.30; 95% CI, 1.21–1.39) were independent predictors of CVE (all P < 0.001). Furthermore, when participants were categorized by both NHR quartile and glucose metabolism status, the NHR level in the highest quartile plus pre-DM group was associated with a 1.60-fold (95% CI, 1.38–1.86; P < 0.001] higher risk of CVE than that in the lowest quartile plus normoglycemic group. Significantly, the addition of NHR only, presence of pre-DM only, or combination of NHR and pre-DM to the prediction algorithm, including traditional risk factors, improved the C-statistic by 0.19, 0.05, and 0.23 (all P < 0.001). Conclusions Elevated NHR or fasting blood glucose level were independently associated with a higher risk of CVE among normoglycemic individuals. Moreover, pre-DM participants with high NHR levels tended to have worse prognosis, suggesting that NHR could provide greater risk stratification value than traditional risk factors for subjects with pre-DM.

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Non-alcoholic Fatty Liver Disease Is Associated With Cardiovascular Outcomes in Subjects With Prediabetes and Diabetes: A Prospective Community-Based Cohort Study

Cited by 8 publications

References 42 publications

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Racial/ethnic and gender disparity in the severity of NAFLD among people with diabetes or prediabetes

Relationship Between Plasma Aldosterone Concentrations and Non-Alcoholic Fatty Liver Disease Diagnosis in Patients with Hypertension: A Retrospective Cohort Study

Neutrophil to high-density lipoprotein cholesterol ratio predicts adverse cardiovascular outcomes in subjects with pre-diabetes: a large cohort study from China

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