1. Apolipoproteins and liver parameters optimize cardiovascular disease risk-stratification in nonalcoholic fatty liver disease
- Author
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Weiyi Mai, Congxiang Shao, Bihui Zhong, Xin Li, Junzhao Ye, Wei Wang, Fuxi Li, Yansong Lin, Xiaorong Gong, Tingfeng Wu, Qianqian Ma, and Shi-Ting Feng
- Subjects
Adult ,medicine.medical_specialty ,Apolipoprotein B ,Comorbidity ,Risk Assessment ,Severity of Illness Index ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Fibrosis ,Internal medicine ,Nonalcoholic fatty liver disease ,Humans ,Medicine ,Retrospective Studies ,Ultrasonography ,Subclinical infection ,Framingham Risk Score ,Hepatology ,biology ,business.industry ,Fatty liver ,nutritional and metabolic diseases ,Retrospective cohort study ,Middle Aged ,medicine.disease ,digestive system diseases ,Causality ,Apolipoproteins ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,biology.protein ,030211 gastroenterology & hepatology ,Steatosis ,business ,Biomarkers - Abstract
Advanced Non-alcoholic fatty liver disease (NAFLD) is associated with increased risk of cardiovascular disease (CVD).We determine whether combinations of ultrasound graphic steatosis grades, fibrosis scores and apolipoprotein levels add value to CVD risk prediction in NAFLD patients.The retrospective cohort study enrolled 10,453 individuals (3519 NAFLD; 6934 non NAFLD) from 2004 to 2018. Hepatic ultrasound measurements, lipid and apolipoprotein profiles, Fibrosis-4 and the NAFLD fibrosis scores (NFS) were assessed. The primary outcome included both clinical and subclinical CVD.During 116-month follow-up period, there were 957 clinical and 752 subclinical CVD events. NAFLD patients had a higher incidence of CVD than non NAFLD patients as the steatosis degree, NFS, and FIB4 scores increased (25.1% vs 11.9%, Log Rank: p 0.001). For the lipid and apolipoprotein profiles excluding triglyceride or ApoE, subjects with varied steatosis severity in the upper two tertiles had different risk of CVD (p for interaction 0.001). A nomogram model combination of Framingham Risk Score (FRS), NFS and apolipoprotein profiles presented a higher AUC than FRS in a time-dependent ROC curve (0.816 vs 0.752, p 0.001).The novel risk score considering ultrasonography-defined steatosis grades, non-invasive liver fibrosis scores and apolipoprotein profiles accurately predicted the 10-year risk of CVD.
- Published
- 2021
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