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Ideal cardiovascular health associated with fatty liver: Results from a multi-ethnic survey

  • Mohsen Mazidi
    Correspondence
    Corresponding author.
    Affiliations
    Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, China

    Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), Chaoyang, China
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  • Niki Katsiki
    Affiliations
    Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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  • Dimitri P. Mikhailidis
    Affiliations
    Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
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  • Maciej Banach
    Affiliations
    Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland

    Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland

    Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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      Highlights

      • To investigate the association between the cardiovascular health score (CVH) score, liver enzyme biomarkers and the risk of non-alcoholic fatty liver disease (NAFLD).
      • Individuals with a higher CVH score had a more favorable profile of liver biomarkers.
      • Individuals with a higher CVH score had 12% less likelihood of NAFLD compared with those with a lower score.
      • Each CVH component separately was associated with the risk of NAFLD.

      Abstract

      Background and aims

      Little is known about the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The ideal cardiovascular health (CVH) score proposed by the American Heart Association (AHA) can be used to predict mortality and morbidity. We investigated the association of the CVH score with liver enzymes and the risk of non-alcoholic fatty liver disease (NAFLD) among US adults.

      Methods

      By using the National Health and Nutrition Examination Survey database (cross-sectional), the CVH score was calculated as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity and diet adherence) and 3 factors (total cholesterol, blood pressure and fasting glucose).

      Results

      Individuals with a higher CVH score (“better CVH”) had a more favorable profile of liver biomarkers. Adjusted (for age, gender, race, poverty to income ratio, education, marital status and alcohol intake) linear regression indicated significant and negative associations between liver biomarkers and CVH score: (β = −0.069, p < 0.001) for alanine aminotransferase, (β = −0.095, p < 0.001), aspartate aminotransferase, (β = −0.067, p < 0.001), alkaline phosphatase and (β = −0.125, p < 0.001) and fatty liver index. In the logistic regression, with the same confounders, individuals with a higher CVH score had 12% less likelihood of NAFLD compared with those with a lower score. Furthermore, each CVH metric separately was inversely linked to the risk of NAFLD.

      Conclusions

      For the first time among US adults, our findings shed light on the role CVH on liver biomarkers.

      Keywords

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