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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1433807

Association between fatty liver index and cardiometabolic multimorbidity: Evidence from the Cross-sectional National Health and Nutrition Examination Survey

Provisionally accepted
Xinsheng Gu Xinsheng Gu 1*Di Gao Di Gao 1*Xinjian Zhou Xinjian Zhou 1*Yueyou Ding Yueyou Ding 1*Wenrui Shi Wenrui Shi 2Jieun Park Jieun Park 3*Shaohui Wu Shaohui Wu 4*Yue He Yue He 1*
  • 1 Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China
  • 2 Zhongshan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
  • 3 School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China
  • 4 Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: Metabolic dysfunction associated steatotic liver disease (MASLD) contributes to the cardiometabolic diseases through multiple mechanisms. Fatty liver index (FLI) has been formulated as a non-invasive, convenient, and cost-effective approach to estimate the degree of MASLD. The current study aims to evaluate the correlation between FLI and the prevalent cardiometabolic multimorbidity (CMM), and to assess the usefulness of FLI to improve the detection of the prevalent CMM in the general population.Methods: 26269 subjects were enrolled from the National Health and Nutrition Examination Survey 1999-2018. FLI was formulated based on triglycerides, body mass index, γ -glutamyltransferase, and waist circumference. CMM was defined as a history of 2 or more of diabetes mellitus, stroke, myocardial infarction.The prevalence of CMM was 10.84%. With adjustment of demographic, anthropometric, laboratory, and medical history covariates, each standard deviation of FLI leaded to a 58.8% risk increase for the prevalent CMM. The fourth quartile of FLI had a 2.424 times risk for the prevalent CMM than the first quartile, and a trend towards higher risk was observed. Smooth curve fitting showed that the risk for prevalent CMM increased proportionally along with the elevation of FLI. Subgroup analysis demonstrated that the correlation was robust in several conventional subpopulations. Receiver-operating characteristic curve analysis revealed an incremental value of FLI for detecting prevalent CMM when adding it to conventional cardiometabolic risk factors (Area under the curve: 0.920 vs 0.983, P<0.001).Results from reclassification analysis confirmed the improvement from FLI.Our study demonstrated a positive, linear, and robust correlation between FLI and the prevalent CMM, and our findings implicate the potential usefulness of FLI to improve the detection of prevalent CMM in the general population.

    Keywords: Non-alcoholic fatty liver disease, Fatty liver index, cardiometabolic multimorbidity, NHANES, general population

    Received: 16 May 2024; Accepted: 13 Aug 2024.

    Copyright: © 2024 Gu, Gao, Zhou, Ding, Shi, Park, Wu and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xinsheng Gu, Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China
    Di Gao, Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China
    Xinjian Zhou, Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China
    Yueyou Ding, Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China
    Jieun Park, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, Shanghai Municipality, China
    Shaohui Wu, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
    Yue He, Shanghai Eighth People Hospital, Shanghai, Shanghai Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.