Skip to main content

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1491611

Association Between Liver Fibrosis Scores and Cardiovascular Disease in the Elderly: Results from NHANES (1999-2018)

Provisionally accepted
Man Du Man Du Yuan Li Yuan Li Jiangtao Du Jiangtao Du Jianqiang Song Jianqiang Song Shitao Sun Shitao Sun Wanwan Guo Wanwan Guo Lifeng Zhu Lifeng Zhu Shimian Guo Shimian Guo *
  • Nanyang First People's Hospital, Nanyang, China

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

    Abstract Objective: This study aimed to assess the association between liver fibrosis scores (LFSs) and cardiovascular disease (CVD) in older adults, investigating the mediating effect of total bilirubin (TBil) between LFSs and CVD. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018, this cross-sectional study analyzed Americans aged 60 and older. Four LFSs (Forns Score, FIB-4, NAFLD fibrosis score, and BARD Score) were utilized. Weighted logistic regression and smoothed curve fitting explored the relationship between LFSs and CVD. Subgroup analysis assessed this relationship among different populations. Mediation effect analysis examined the role of TBil. Results: This study included 18,902 subjects, with a mean age of 69.64±7.00 years and CVD prevalence of 22.33%. The fully adjusted weighted logistic regression models showed that FS, NFS, FIB-4 and BARD Score were positively associated with CVD with ORs of 1.50 (95% CI:1.37-1.64), 1.50 (95% CI:1.30-1.73), 1.39 (95% CI:1.18-1.64), and 1.54 (95% CI:1.29-1.85). Smoothed curve fitting indicated a nonlinear correlation between LFSs and CVD. Subgroup analysis indicated that the positive associations between FS, NFS, FIB-4, and CVD were consistent with respect to hepatitis B surface antigen, and the positive correlation between FIB-4, BARD Score, and CVD was coherent for the prevalence of hypertension. Mediation analysis revealed TBil mediated 12.61% of the association between FIB-4 and CVD. Conclusion: There exists a positive association between LFSs and CVD in older adults, and TBil mediates the relationship between FIB-4, and CVD. LFSs may serve as a tool for identifying older adults at high risk for cardiovascular disease.

    Keywords: Liver fibrosis scores, cardiovascular disease, Total bilirubin, the elderly, mediation effect

    Received: 05 Sep 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Du, Li, Du, Song, Sun, Guo, Zhu and Guo. 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: Shimian Guo, Nanyang First People's Hospital, Nanyang, 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.