| 제목 | Non-alcoholic fatty liver disease and the incidence of myocardial infarction: A cohort study. | ||
|---|---|---|---|
| 작성자 | 관리자 | 등록일 | 2019-12-13 |
내용
J Gastroenterol Hepatol. 2019 Sep 11. doi: 10.1111/jgh.14856. [Epub ahead of print]
Non-alcoholic fatty liver disease and the incidence of myocardial infarction: A cohort study.
Sinn DH1, Kang D2, Chang Y3, Ryu S3, Cho SJ4, Paik SW1, Song YB1, Pastor-Barriuso R5,6, Guallar E7,8, Cho J2,7,8, Gwak GY1.
Author information
- 1
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 2
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
- 3
- Center for Total Health Studies, Kangbuk Samsung Hospital, Seoul, Korea.
- 4
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea.
- 5
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
- 6
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- 7
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.
- 8
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Abstract
BACKGROUND AND AIM:
Non-alcoholic fatty liver disease (NAFLD) is a multisystem disease associated with an increased risk of cardiovascular disease (CVD), diabetes, and chronic kidney disease. Indeed, CVD is the most common cause of death in NAFLD patients. This study aimed to evaluate the association between NAFLD and the risk of incident myocardial infarction.
METHODS:
This is a retrospective cohort study involving 111 492 adults over 40 years old without history of CVD, liver disease, or cancer at baseline who participated in a regular health screening exam between 2003 and 2013. Fatty liver was diagnosed by ultrasonography.
RESULTS:
During 725 706.9 person-years of follow-up, 183 participants developed myocardial infarction (incidence rate 0.3 cases per 1000 person-years). The age, sex, and year of visit-adjusted hazard ratio (HR) for incident myocardial infarction comparing participants with NAFLD with those without it was 2.14 (95% confidence interval 1.59, 2.89). This association remained significant in fully adjusted models (HR 1.54; 95% confidence interval 1.11, 2.14). Compared with participants without NAFLD, in participants with low NAFLD fibrosis score (NFS) (< -1.455) and with intermediate-to-high NFS (≥ -1.455), the fully adjusted HRs for incident myocardial infarction were 1.70 (1.22, 2.36) and 1.88 (1.24, 2.87), respectively.
CONCLUSION:
In this large cohort study, NAFLD was associated with an increased incidence of myocardial infarction independently of established risk factors. In addition, this association was similar in participants with and without evidence of more advanced NAFLD as indicated by the NFS. NAFLD patients may need to be carefully monitored and managed early to prevent myocardial infarction.
© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
