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Comparison of all-cause mortality associated with non-alcoholic fatty liver disease and metabolic dysfunction-associated fatty liver disease in Taiwan MJ cohort
Wei-Chun Cheng, Hua-Fen Chen, Hsiu-Chi Cheng, Chung-Yi Li
Epidemiol Health. 2024;46:e2024024.   Published online January 21, 2024
DOI: https://doi.org/10.4178/epih.e2024024
  • 2,082 View
  • 92 Download
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The global burden of non-alcoholic fatty liver disease (NAFLD) is rising. An alternative term, metabolic dysfunction-associated fatty liver disease (MAFLD), instead highlights the associated metabolic risks. This cohort study examined patient classifications under NAFLD and MAFLD criteria and their associations with all-cause mortality.
METHODS
Participants who attended a paid health check-up (2012-2015) were included. Hepatic steatosis (HS) was diagnosed ultrasonographically. NAFLD was defined as HS without secondary causes, while MAFLD involved HS with overweight/obesity, type 2 diabetes mellitus, or ≥2 metabolic dysfunctions. Mortality was tracked via the Taiwan Death Registry until November 30, 2022.
RESULTS
Of 118,915 participants, 36.9% had NAFLD, 40.2% had MAFLD, and 32.9% met both definitions. Participants with NAFLD alone had lower mortality, and those with MAFLD alone had higher mortality, than individuals with both conditions. After adjustment for potential confounders, the hazard ratios (HRs) for all-cause mortality were 1.08 (95% confidence interval [CI], 0.78 to 1.48) for NAFLD alone and 1.26 (95% CI, 1.09 to 1.47) for MAFLD alone, relative to both conditions. Advanced fibrosis conferred greater mortality risk, with HRs of 1.93 (95% CI, 1.44 to 2.58) and 2.08 (95% CI, 1.61 to 2.70) for advanced fibrotic NAFLD and MAFLD, respectively. Key mortality risk factors for NAFLD and MAFLD included older age, unmarried status, higher body mass index, smoking, diabetes mellitus, chronic kidney disease, and advanced fibrosis.
CONCLUSIONS
All-cause mortality in NAFLD and/or MAFLD was linked to cardiometabolic covariates, with risk attenuated after multivariable adjustment. A high fibrosis-4 index score, indicating fibrosis, could identify fatty liver disease cases involving elevated mortality risk.
Summary
Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men
Mounir Ould Setti, Ari Voutilainen, Tomi-Pekka Tuomainen
Epidemiol Health. 2021;43:e2021001.   Published online December 24, 2020
DOI: https://doi.org/10.4178/epih.e2021001
  • 12,842 View
  • 369 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver.
METHODS
Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver.
RESULTS
Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality.
CONCLUSIONS
RHF and fatty liver are independently associated with all-cause and CVD mortality
Summary
Key Message
Both prevalent, underdiagnosed, and commonly coexisting, renal hyperfiltration and fatty liver are two notable independent risk factors of all-cause and cardiovascular disease mortality.

Citations

Citations to this article as recorded by  
  • Impact of gout on cardiovascular disease mortality: a meta-analysis
    Jielin Yuan, Zhitao Xie, Bo Pan, Jingchang Zhang
    Zeitschrift für Rheumatologie.2024;[Epub]     CrossRef
  • Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data
    Atsushi Kitazawa, Yoshiharu Fukuda
    BMC Nephrology.2023;[Epub]     CrossRef
  • Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population
    Andrea Dalbeni, Marta Garbin, Mirko Zoncapè, Sara Romeo, Filippo Cattazzo, Anna Mantovani, Annalisa Cespiati, Anna Ludovica Fracanzani, Emmanouil Tsochatzis, David Sacerdoti, Alessandro Mantovani, Rosa Lombardi
    International Journal of Molecular Sciences.2023; 24(21): 15837.     CrossRef
  • Fatty Liver Index Independently Predicts All-Cause Mortality in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis but No Substantial Liver Disease
    Pil Gyu Park, Jung Yoon Pyo, Sung Soo Ahn, Hyun Joon Choi, Jason Jungsik Song, Yong-Beom Park, Ji Hye Huh, Sang-Won Lee
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
The Prevalence Rate of Fatty Liver and Its Risk Factors of Adult Women in a Rural Area.
June Young Suh, Byung Yeol Chun, Hee Jung Yoon, Kyung Eun Lee, Sam Soon Lee
Korean J Epidemiol. 2003;25(2):100-107.
  • 5,392 View
  • 14 Download
AbstractAbstract PDF
Abstract
PURPOSE
To investigate the prevalence rate of fatty liver disease and its related factors of women in rural area.
METHODS
Seven hundreds and fifty four adult females (above age 30) at eleven Community Health Centers in Koryung County were recruited from 3 March 2001 to 30 May 2001. Abdominal ultrasonography, height, weight, and blood pressure were measured. A questionnaire interviewing method was used to collect life style data.
RESULTS
The prevalence of fatty liver disease was 13.4%. By simple analysis, age(p<0.05), diabetes mellitus(p<0.01), salt intake(p<0.05), and obesity (p<0.01) were significantly associated with fatty liver disease. In multiple logistic regression analysis, the risk for fatty liver in above 50 age group was 2.7 (95% CI: 1.25-5.99) times higher than that in 30-49 age group, overweight was 10.3 (95% CI: 5.26-19.99) times higher than normal group, 3.9 times (95% CI: 1.84-8.38) higher in person with diabetes mellitus than those without and the risk of current drinkers was 2.0 times (95% CI: 1.03-3.85) higher than non-drinkers.
CONCLUSION
Above findings suggested that risk factors significantly related with fatty liver were age, BMI, diabetes mellitus, and drinking in adult women.
Summary
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