Highlights
- •Persistent NAFLD showed increased risk of myocardial infarction, stroke, heart failure, and mortality compared with non-NAFLD.
- •Regression NAFLD was associated with decreased risk HF and mortality compared with persistent NAFLD.
- •Persistent hepatic fibrosis was associated with increased risk of stroke, heart failure and mortality compared with non-fibrosis.
- •Compared with persistent hepatic fibrosis, regression of hepatic fibrosis demonstrated decreased risk of MI, stroke, HF, and mortality.
- •Changes in hepatic steatosis and fibrosis based on FLI or BARD score could identify higher risk group for CVD and mortality among new-onset T2DM.
Abstract
Aim
Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) have
a synergistic effect on cardiovascular disease (CVD). We investigated the association
of changes in hepatic steatosis and advanced hepatic fibrosis with risk of CVD and
mortality in new-onset T2DM.
Methods
Using the Korean National Health Insurance dataset, we included 120,256 patients with
new-onset T2DM. Hepatic steatosis and advanced hepatic fibrosis were determined using
the fatty liver index (FLI) and BARD score. According to the changes of the two scores
over two years, patients were divided into four groups and analyzed for development
of myocardial infarction (MI), stroke, heart failure (HF), and mortality.
Results
Incident hepatic steatosis was associated with increased development of stroke, HF,
and mortality compared with non-NAFLD (all p < 0.05). Regression and persistent hepatic
steatosis were associated with increased risk of MI, stroke, HF, and mortality compared
with non-NAFLD (all p < 0.05). Persistent advanced hepatic fibrosis was associated
with increased risk of stroke, HF, and mortality (all p < 0.05).) Compared with persistent
hepatic fibrosis, regression of hepatic fibrosis was associated with decreased risk
of stroke, HF, and mortality (all p < 0.05).
Conclusions
Changes in FLI or BARD score were associated with CVD and mortality in new-onset T2DM.
Keywords
Abbreviations:
BMI (body mass index), CI (confidence interval), CVD (cardiovascular disease), FLI (fatty liver index), HF (heart failure), HR (hazard ratio), MI (myocardial infarction), NAFLD (Nonalcoholic fatty liver disease)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 26, 2022
Accepted:
November 23,
2022
Received in revised form:
November 17,
2022
Received:
October 22,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
