Non-invasive hepatic steatosis and fibrosis indices predict differentially mortality in the adult Korean population.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Clinical Gastroenterology and Hepatology Pub Date : 2024-10-25 DOI:10.1016/j.cgh.2024.10.006

Young-Gyun Seo, Stergios A Polyzos, Kyung-Hee Park, Christos S Mantzoros

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Abstract

Background and aims: Since the association of hepatic fibrosis and steatosis non-invasive indices with mortality remain controversial, their association with all-cause, cardiovascular, cancer and liver-related mortality was evaluated in the Korean population.

Methods: In this registry-based, cohort study, data were retrieved from the Korea National Health and Nutrition Examination Survey and mortality data from the Korean Cause of Death data registry; 40,491 individuals followed-up for 8.6 years (median). Hepatic fibrosis was evaluated with alanine aminotransferase (AST)-to-platelet ratio index (APRI), body mass index-AST-to-alanine aminotransferase (ALT) ratio-diabetes mellitus (BARD) and metabolic dysfunction-associated fibrosis-5 (MAF-5) score, and steatosis was evaluated with liver fat score (LFS) and lipid accumulation product (LAP).

Results: Cox regression analysis showed that APRI (<1.0 vs. ≥1.0) was independently associated with all-cause (hazard ratio [HR] 3.84, 95% confidence interval [CI] 2.30-6.43, C-index 0.870), cancer (HR 4.21, 95%CI 1.88-9.45, C-index 0.866) and liver-related (HR 25.36, 95%CI 11.02-58.38, C-index 0.909) mortality. MAF-5 (<1.0 vs. ≥1.0) was independently associated with all-cause mortality (HR 1.50, 95%CI 1.10-2.03, C-index 0.868) and liver-related mortality (HR 8.35, 95%CI 3.58-19.46, C-index 0.911). LFS (<1.257 vs. ≥1.257), was independently associated with all-cause (HR 1.55, 95%CI 1.14-2.12, C-index 0.872) and liver-related (HR 7.00, 95%CI 1.63-29.96, C-index 0.887) mortality. LAP (<38.05 vs. ≥38.05) was independently associated with cardiovascular mortality (HR 2.23, 95%CI 1.40-3.58, C-index 0.898). BARD was not associated with mortality.

Conclusions: APRI, MAF-5, LFS were independently associated with all-cause mortality, LAP (cut-off 38.05) with cardiovascular mortality, APRI with cancer mortality, and APRI, MAF-5, LFS with liver-related mortality in the adult Korean population.

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非侵入性肝脂肪变性和肝纤维化指数可预测韩国成年人群的不同死亡率。

背景和目的：由于肝纤维化和脂肪变性非侵入性指数与死亡率的关系仍存在争议，因此在韩国人群中评估了它们与全因死亡率、心血管死亡率、癌症死亡率和肝脏相关死亡率的关系：在这项以登记为基础的队列研究中，数据来自韩国国民健康与营养调查，死亡率数据来自韩国死因数据登记；40 491 人接受了 8.6 年（中位数）的随访。肝纤维化用丙氨酸氨基转移酶（AST）-血小板比值指数（APRI）、体重指数-AST-丙氨酸氨基转移酶（ALT）比值-糖尿病（BARD）和代谢功能障碍相关纤维化-5（MAF-5）评分进行评估，脂肪变性用肝脏脂肪评分（LFS）和脂质累积乘积（LAP）进行评估：结果：Cox 回归分析表明，APRI（结论：APRI、MAF-5、LAP结果：Cox 回归分析表明，在韩国成年人群中，APRI、MAF-5 和 LFS 与全因死亡率独立相关，LAP（临界值 38.05）与心血管死亡率独立相关，APRI 与癌症死亡率独立相关，APRI、MAF-5 和 LFS 与肝脏相关死亡率独立相关。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.