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Non-Alcoholic Fatty Liver Disease Defined by Fatty Liver Index and Incidence of Heart Failure in the Korean Population: A Nationwide Cohort Study

Authors
Han, ByoungduckLee, Gyu BaeYim, Sun YoungCho, Kyung-HwanShin, Koh EunKim, Jung-HwanPark, Yong-GyuHan, Kyung-DoKim, Yang-Hyun
Issue Date
3월-2022
Publisher
MDPI
Keywords
heart failure; non-alcoholic fatty liver disease; fatty liver index; waist circumference; obesity
Citation
DIAGNOSTICS, v.12, no.3
Indexed
SCIE
SCOPUS
Journal Title
DIAGNOSTICS
Volume
12
Number
3
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/140104
DOI
10.3390/diagnostics12030663
ISSN
2075-4418
Abstract
Fatty liver index (FLI) is a simple and useful index that evaluates non-alcoholic fatty liver disease (NAFLD), particularly in large epidemiologic studies. Heart failure (HF) is becoming a burden to public health as the global trend toward an aging society continues. Thus, we investigated the effect of FLI on the incidence of HF using large cohort data from the Korean National Health Insurance health database. Methods and Results: A total of 7,958,538 subjects aged over 19 years without baseline HF (men = 4,142,264 and women = 3,816,274) were included. Anthropometric and biochemical measurements were evaluated. FLI scores were calculated and FLI >= 60 was considered as having NAFLD. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HF incidence were analysed using multivariable time-dependent Cox proportional hazard models. During a mean follow up of 8.26 years, 17,104 participants developed HF. The FLI components associated with the incidence of HF and FLI showed a causal relationship with HF; the FLI >= 60 group had a higher HR for HF (HR 1.493; 95% CIs 1.41-1.581) than the FLI < 30 group. Subgroup analysis showed that fatty liver (FLI >= 60) with age >= 65 years or women displayed higher HR for HF than fatty liver with age < 65 or men, respectively. An increase in FLI score significantly increased the HR for HF except for those with a FLI score change from <30 to 30-60. Conclusion: NAFLD defined by FLI and increase in FLI score were associated with the incidence of HF. Further detailed prospective studies are needed.
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