Young-Gyun Seo, Stergios A Polyzos, Kyung-Hee Park, Christos S Mantzoros
{"title":"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。","authors":"Young-Gyun Seo, Stergios A Polyzos, Kyung-Hee Park, Christos S Mantzoros","doi":"10.1016/j.cgh.2024.10.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background & aims: </strong>Because 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.</p><p><strong>Methods: </strong>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 a median of 8.6 years. 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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>APRI, MAF-5, and LFS were independently associated with all-cause mortality, LAP (cutoff, 38.05) with cardiovascular mortality, APRI with cancer mortality, and APRI, MAF-5, and LFS with liver-related mortality in the adult Korean population.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6000,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Noninvasive Hepatic Steatosis and Fibrosis Indices Differentially Predict Mortality in the Adult Korean Population.\",\"authors\":\"Young-Gyun Seo, Stergios A Polyzos, Kyung-Hee Park, Christos S Mantzoros\",\"doi\":\"10.1016/j.cgh.2024.10.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background & aims: </strong>Because 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.</p><p><strong>Methods: </strong>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 a median of 8.6 years. 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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>APRI, MAF-5, and LFS were independently associated with all-cause mortality, LAP (cutoff, 38.05) with cardiovascular mortality, APRI with cancer mortality, and APRI, MAF-5, and LFS with liver-related mortality in the adult Korean population.</p>\",\"PeriodicalId\":10347,\"journal\":{\"name\":\"Clinical Gastroenterology and Hepatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":11.6000,\"publicationDate\":\"2024-10-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cgh.2024.10.006\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cgh.2024.10.006","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Noninvasive Hepatic Steatosis and Fibrosis Indices Differentially Predict Mortality in the Adult Korean Population.
Background & aims: Because 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 a median of 8.6 years. 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, and LFS were independently associated with all-cause mortality, LAP (cutoff, 38.05) with cardiovascular mortality, APRI with cancer mortality, and APRI, MAF-5, and LFS with liver-related mortality in the adult Korean population.
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.
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