Correlation of the Fatty Liver Index with the Pathophysiological Abnormalities Associated with Cardiovascular Risk Markers in Japanese Men without any History of Cardiovascular Disease: Comparison with the Fibrosis-4 Score

AbstractFatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. This study aimed to evaluate the relationship between FLI and new onset of diabetes mellitus (DM). We investigated the association of FLI with new onset of DM during a 10-year period in subjects who received annual health examinations (n = 28,990). After exclusion of subjects with DM at baseline and those with missing data, a total of 12,290 subjects (male/female: 7925/4365) who received health examinations were recruited. FLI was significantly higher in males than in females. During the 10-year period, DM was developed in 533 males (6.7%) and 128 females (2.9%). Multivariable Cox proportional hazard models with a restricted cubic spline showed that the risk of new onset of DM increased with a higher FLI at baseline in both sexes after adjustment of age, fasting plasma glucose, habits of alcohol drinking and current smoking, family history of DM and diagnosis of hypertension and dyslipidemia at baseline. When the subjects were divided into subgroups according to tertiles of FLI level at baseline (T1–T3) in the absence and presence of impaired fasting glucose (IFG), hazard ratios after adjustment of the confounders gradually increased from T1 to T3 and from the absence to presence of IFG in both male and female subjects. In conclusion, a high level of FLI predicts new onset of DM in a general population of both male and female individuals.

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Elevated fatty liver index as a risk factor for all-cause mortality in HIV-HCV co-infected patients

European Journal of Public Health ◽

10.1093/eurpub/ckz186.213 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

T Barré ◽

C Protopopescu ◽

F Bani-Sadr ◽

L Piroth ◽

P Sogni ◽

...

Keyword(s):

Risk Factor ◽

Fatty Liver ◽

Clinical Signs ◽

People Living With Hiv ◽

Metabolic Complications ◽

Non Invasive ◽

Liver Index ◽

Fatty Liver Index ◽

All Cause Mortality ◽

History Of

Abstract Background Thanks to innovation in treatment, people living with HIV and/or HCV now live longer but are growingly facing non-communicable disease burden. HIV-HCV co-infected patients are at high risk of metabolic complications and liver-related events, which are both associated with hepatic steatosis and its progressive form, non-alcoholic steatohepatitis (NASH), a known risk factor for mortality. The fatty liver index (FLI), a non-invasive steatosis biomarker, has recently drawn attention for its clinical prognostic value, but has never been applied to HIV-HCV co-infected patients. We aimed at testing whether elevated FLI (≥60) was associated with all-cause mortality in co-infected patients. Methods Our study is based on data from ANRS CO13 HEPAVIH, a French national prospective cohort of HIV-HCV co-infected patients. Socio-behavioral and clinical data from patients clinically followed-up were used in the analysis. Using a Cox proportional hazards model for mortality from all causes (983 patients; 4,432 visits), we computed hazard ratios associated with risk factors and confounders. Results After multiple adjustment, individuals with FLI≥60 had almost double the risk of all-cause mortality (adjusted hazard ratio [95% confidence interval]: 1.91 [1.17-3.12], p = 0.009), independently of HCV cure (0.21 [0.07-0.61], p = 0.004), advanced fibrosis (1.77 [1.00-3.14], p = 0.05), history of hepatocellular carcinoma and/or liver transplantation (7.74 [3.82-15.69], p < 10-3), history of indirect clinical signs of cirrhosis (2.80 [1.22-6.41], p = 0.015), and HIV CDC clinical stage C (2.88 [1.74-4.79], p < 10-3). Conclusions An elevated fatty liver index is a risk factor for all-cause mortality in HIV-HCV co-infected patients independently of liver fibrosis and HCV cure. In the present era of nearly 100% HCV cure rates, these findings encourage the more systematic use of non-invasive steatosis biomarkers to help identify co-infected patients with higher mortality risk. Key messages A FLI≥60 is strongly associated with mortality in HIV-HCV co-infected patients. FLI could be calculated routinely to identify most at-risk patients.

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Fatty Liver Index and Development of Cardiovascular Disease: Findings from the UK Biobank

Digestive Diseases and Sciences ◽

10.1007/s10620-021-06954-y ◽

2021 ◽

Author(s):

Biyao Zou ◽

Yee Hui Yeo ◽

Ramsey Cheung ◽

Erik Ingelsson ◽

Mindie H. Nguyen

Keyword(s):

Cardiovascular Disease ◽

Fatty Liver ◽

Uk Biobank ◽

Liver Index ◽

Fatty Liver Index ◽

The Uk

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Elevated Fatty Liver Index Is Independently Associated With New Onset of Hypertension During a 10‐Year Period in Both Male and Female Subjects

Journal of the American Heart Association ◽

10.1161/jaha.121.021430 ◽

2021 ◽

Author(s):

Yukimura Higashiura ◽

Masato Furuhashi ◽

Marenao Tanaka ◽

Satoko Takahashi ◽

Kazuma Mori ◽

...

Keyword(s):

Fatty Liver ◽

Distribution Patterns ◽

Nonalcoholic Fatty Liver ◽

Liver Index ◽

Fatty Liver Index ◽

Hazard Ratios ◽

History Of ◽

Traditional Risk Factors ◽

High Level ◽

New Onset

Background Fatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. Because of a sex difference in FLI level, we hypothesized that FLI is associated with development of hypertension to a greater extent in men or women. Methods and Results We investigated the relationship between FLI and development of hypertension during a 10‐year period in a general population of subjects who received annual health examinations (n=28 990). After exclusion (44.9%) of subjects with missing data and those with hypertension at baseline, a total of 15 965 subjects (men/women: 9466/6499) were included. FLI level was significantly higher in men than in women. During the 10‐year period, 2304 men (24.3%) and 745 women (11.5%) had new onset of hypertension. Multivariable Cox proportional hazard models with a restricted cubic spline showed that the hazard ratios (HRs) for development of hypertension after adjustment of age, systolic blood pressure, estimated glomerular filtration rate, habits of smoking and alcohol drinking, family history of hypertension, and diagnosis of diabetes mellitus and dyslipidemia increased gradually with increase in FLI in men and increased rapidly and then slowly with increase in FLI in women. There was a significant interaction between FLI and sex for the risk of hypertension in all of the subjects ( P =0.049). The addition of FLI to traditional risk factors significantly improved the discriminatory capability. Conclusions A high level of FLI predicts the development of hypertension in both men and women, although distribution patterns of HRs were different between sexes.

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Fatty liver index and development of cardiovascular disease in Koreans without pre-existing myocardial infarction and ischemic stroke: a large population-based study

Cardiovascular Diabetology ◽

10.1186/s12933-020-01025-4 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Jun Hyung Kim ◽

Jin Sil Moon ◽

Seok Joon Byun ◽

Jun Hyeok Lee ◽

Dae Ryong Kang ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Ischemic Stroke ◽

Fatty Liver ◽

Large Population ◽

Population Based ◽

Population Based Study ◽

Liver Index ◽

Fatty Liver Index

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Fatty Liver Index and Lipid Accumulation Product Can Predict Metabolic Syndrome in Subjects without Fatty Liver Disease

Gastroenterology Research and Practice ◽

10.1155/2017/9279836 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 5

Author(s):

Yuan-Lung Cheng ◽

Yuan-Jen Wang ◽

Keng-Hsin Lan ◽

Teh-Ia Huo ◽

Yi-Hsiang Huang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Liver Disease ◽

Fatty Liver ◽

Lipid Accumulation ◽

Fatty Liver Disease ◽

Lipid Accumulation Product ◽

Liver Index ◽

Fatty Liver Index ◽

Better Than

Background. Fatty liver index (FLI) and lipid accumulation product (LAP) are indexes originally designed to assess the risk of fatty liver and cardiovascular disease, respectively. Both indexes have been proven to be reliable markers of subsequent metabolic syndrome; however, their ability to predict metabolic syndrome in subjects without fatty liver disease has not been clarified.Methods. We enrolled consecutive subjects who received health check-up services at Taipei Veterans General Hospital from 2002 to 2009. Fatty liver disease was diagnosed by abdominal ultrasonography. The ability of the FLI and LAP to predict metabolic syndrome was assessed by analyzing the area under the receiver operating characteristic (AUROC) curve.Results. Male sex was strongly associated with metabolic syndrome, and the LAP and FLI were better than other variables to predict metabolic syndrome among the 29,797 subjects. Both indexes were also better than other variables to detect metabolic syndrome in subjects without fatty liver disease (AUROC: 0.871 and 0.879, resp.), and the predictive power was greater among women.Conclusion. Metabolic syndrome increases the cardiovascular disease risk. The FLI and LAP could be used to recognize the syndrome in both subjects with and without fatty liver disease who require lifestyle modifications and counseling.

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Fatty liver index and development of cardiovascular disease in Koreans without pre-existing cardiovascular disease: a large population-based study

10.21203/rs.2.22994/v1 ◽

2020 ◽

Author(s):

Jun Hyung Kim ◽

Jin Sil Moon ◽

Seok Joon Byun ◽

Jun Hyeok Lee ◽

Dae Ryong Kang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Ischemic Stroke ◽

Fatty Liver ◽

Primary Endpoint ◽

Large Population ◽

Cardiovascular Death ◽

Population Based ◽

Population Based Study ◽

Liver Index ◽

Fatty Liver Index

Abstract Background Despite the known association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD), it remains uncertain whether NAFLD predicts future CVD events, especially CVD mortality. We evaluated the relationship between fatty liver index (FLI), a validated marker of NAFLD, and risk of major adverse cardiac events (MACE) in a large population-based study. Methods We identified 3,011,588 subjects without a history of CVD who underwent health examinations from 2009 to 2011 in the Korean National Health Insurance System cohort. The primary endpoint was a composite of cardiovascular deaths, non-fatal myocardial infarction (MI), and ischemic stroke. Cox proportional hazards regression analysis was performed to assess the independent association between FLI and the primary endpoint. Results During the median follow-up of 6 years, there were 46,010 cases of MACE (7,148 cases of cardiovascular death, 16,574 non-fatal MI, and 22,228 ischemic stroke). There was a linear association between higher FLI values and higher incidence of the primary endpoint. In the multivariable models adjusted for factors including body weight and cholesterol levels, the hazard ratio (95% CIs) for the primary endpoint comparing the highest vs. lowest quartiles of FLI was 1.99 (1.91–2.07). The corresponding odds ratios (95% CIs) for cardiovascular death, non-fetal MI, and ischemic stroke were 1.98 (1.9-2.06), 2.16 (2.01-2.31), and 2.01 (1.90-2.13), respectively. The results were similar when we stratified analysis by age, sex, dyslipidemia medication, obesity, diabetes, and hypertension. Conclusions Our findings indicate that FLI, a surrogate marker of NAFLD, has prognostic value for detecting individuals at higher risk of cardiovascular events.

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