Nonalcoholic Fatty Liver Disease Associates With Increased Overall Mortality and Death From Cancer, Cardiovascular Disease, and Liver Disease in Women but Not Men

Hwang, Yu-Jin; Ahn, Hong Yup; Park, Sung Woo; Park, Cheol‐Young

doi:10.1016/j.cgh.2017.11.026

Cited by 47 publications

(54 citation statements)

References 27 publications

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“…The remaining participants were those voluntarily taking part in screening examinations. The study population consisted of individuals who participated in a comprehensive health screening program annually at Kangbuk Samsung Hospital in Seoul, Korea, from 2007 to 2013 ( n = 263,234) . We excluded individuals who had any of the following: (1) hepatitis B surface antigen positivity ( n = 8,249), (2) hepatitis C virus antibody positivity ( n = 553), (3) alcohol consumption ≥ 30 g/d in men or ≥ 20 g/d in women ( n = 42,603), (4) missing information regarding fatty liver diagnosed by ultrasonography ( n = 952), or (5) unavailable serum insulin results ( n = 161,600).…”

Section: Methodsmentioning

confidence: 99%

“…NAFLD represents various spectra of liver disorders, ranging from simple steatosis with a benign prognosis to a potentially progressive form of nonalcoholic steatohepatitis. NAFLD is considered to be a hepatic manifestation of metabolic syndrome and is associated with insulin resistance, type 2 diabetes, cardiovascular disease, and overall and cardiovascular mortality .…”

Section: Introductionmentioning

confidence: 99%

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Association Between Nonalcoholic Fatty Liver Disease and Future Deterioration of Metabolic Health: A Cohort Study

Hwang

Ahn

Park

2019

Obesity

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Objective: It was hypothesized that the presence of nonalcoholic fatty liver disease (NAFLD) at baseline predicts future conversion from the metabolically healthy (MH) to the metabolically unhealthy (MU) phenotype according to body fat mass. Methods: A total of 22,551 Korean participants (13,601 men and 8,950 women) aged 18 to 78 years in the Kangbuk Samsung Health Study cohort were enrolled from 2007 to 2013. Results: During a median of 5.1 years of follow-up (interquartile range 2.1-9.8 years), 23.5% (n = 5,298) of MH individuals converted to the MU phenotype. NAFLD at baseline predicted conversion independent of age, sex, BMI, lifestyle factors, individual components of metabolic syndrome, and insulin resistance (HR, 1.29; 95% CI: 1.19-1.39; P < 0.0001). In participants with lower BMI and fat mass, NAFLD was strongly associated with conversion; however, as BMI and fat mass increased, the risk decreased, and there was no association in participants with higher BMI and fat mass (P < 0.0001 for trend). Conclusions: NAFLD at baseline was independently associated with future conversion from the MH to the MU phenotype.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Nonalcoholic Fatty Liver Disease and Future Deterioration of Metabolic Health: A Cohort Study

Hwang

Ahn

Park

2019

Obesity

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“…Global prevalence of NAFLD diagnosed by imaging was estimated to be 25.24% (95% confidence interval [CI]: 22.10‐28.65) in adults . Accumulating evidence suggests that individuals with NAFLD are at increased risk of type 2 diabetes, cardiovascular disease (CVD), and all‐cause mortality . However, there is no approved drug therapy for NAFLD, and the main clinical recommendations are lifestyle modifications, including diet …”

Section: Introductionmentioning

confidence: 99%

“…2 Accumulating evidence suggests that individuals with NAFLD are at increased risk of type 2 diabetes, cardiovascular disease (CVD), and all-cause mortality. 3,4 However, there is no approved drug therapy for NAFLD, and the main clinical recommendations are lifestyle modifications, including diet. 5 Nuts are rich sources of unsaturated fatty acids, fibre, minerals, vitamins, protein and other bioactive compounds such as phenolic antioxidants and phytosterols.…”

Section: Introductionmentioning

confidence: 99%

Association between nut consumption and non‐alcoholic fatty liver disease in adults

Zhang

et al. 2019

Liver International

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Background & Aims Increased nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. Although these factors are closely involved in the pathogenesis of non‐alcoholic fatty liver disease (NAFLD), few studies have focused on the association between nut consumption and NAFLD in the general population. We aimed to investigate the association of nut consumption and NAFLD in an adult population. Methods A total of 23 915 participants from Tianjin Chronic Low‐Grade Systemic Inflammation and Health (TCLSIH) Cohort Study were included in this study. Information on dietary intake was collected using a validated food frequency questionnaire. Abdominal ultrasonography was done to diagnose NAFLD. Multivariable logistic regression was used to assess the association of nut consumption with NAFLD. Results After adjusting for sociodemographic, medical, dietary, and lifestyle variables, the odds ratios (95% confidence interval) for NAFLD across categories of nut consumption were 1.00 (reference) for <1 time/week, 0.91 (0.82, 1.02) for 1 time/week, 0.88 (0.76, 1.02) for 2‐3 times/week, and 0.80 (0.69, 0.92) for ≥4 times/week (P for trend < 0.01). These associations were attenuated but remained significant after further adjustment for blood lipids, glucose, and inflammation markers. Conclusions Higher nut consumption was significantly associated with lower prevalence of NAFLD. Further prospective studies and randomized trials are required to ascertain the causal association between nut consumption and NAFLD.

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“…Nevertheless, some meta-analyses failed to confirm this association [16,20]. Moreover, Hwang et al reported that the association between NAFLD and mortality caused by CVD was observed only in women and not in men [21]. In addition, in a 15-year follow-up study of 2,075 middle-aged Caucasian, FLI was not independently associated with CVD mortality, while it was a significant predictor of increased risk of liver-related mortality [22].…”

Section: Discussionmentioning

confidence: 99%

Fatty liver index and development of cardiovascular disease in Koreans without pre-existing cardiovascular disease: a large population-based study

Kim

Moon

Byun

et al. 2020

Preprint

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KEYWORDS 2 cardiovascular disease, mortality, non-alcoholic fatty liver disease, fatty liver index 3 Abstract Background Despite the known association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD), it remains uncertain whether NAFLD predicts future CVD events, especially CVD mortality. We evaluated the relationship between fatty liver index (FLI), a validated marker of NAFLD, and risk of major adverse cardiac events (MACE) in a large population-based study.Methods We identified 3,011,588 subjects without a history of CVD who underwent health examinations from 2009 to 2011 in the Korean National Health Insurance System cohort. The primary endpoint was a composite of cardiovascular deaths, non-fatal myocardial infarction (MI), and ischemic stroke. Cox proportional hazards regression analysis was performed to assess the independent association between FLI and the primary endpoint.Results During the median follow-up of 6 years, there were 46,010 cases of MACE (7,148 cases of cardiovascular death, 16,574 non-fatal MI, and 22,228 ischemic stroke). There was a linear association between higher FLI values and higher incidence of the primary endpoint. In the multivariable models adjusted for factors including body weight and cholesterol levels, the hazard ratio (95% CIs) for the primary endpoint comparing the highest vs. lowest quartiles of FLI was 1.99(1.91-2.07). The corresponding odds ratios (95% CIs) for cardiovascular death, non-fetal MI, and ischemic stroke were 1.98 (1.9-2.06), 2.16 (2.01-2.31), and 2.01 (1.90-2.13), respectively. The results were similar when we stratified analysis by age, sex, dyslipidemia medication, obesity, diabetes, and hypertension.Conclusions Our findings indicate that FLI, a surrogate marker of NAFLD, has prognostic value for

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Nonalcoholic Fatty Liver Disease Associates With Increased Overall Mortality and Death From Cancer, Cardiovascular Disease, and Liver Disease in Women but Not Men

Cited by 47 publications

References 27 publications

Association Between Nonalcoholic Fatty Liver Disease and Future Deterioration of Metabolic Health: A Cohort Study

Association Between Nonalcoholic Fatty Liver Disease and Future Deterioration of Metabolic Health: A Cohort Study

Association between nut consumption and non‐alcoholic fatty liver disease in adults

Fatty liver index and development of cardiovascular disease in Koreans without pre-existing cardiovascular disease: a large population-based study

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