Data underlying the publication "Fatty Liver Index and mortality after myocardial infarction: A prospective analysis in the Alpha Omega Cohort"

Data in this repository consists of the metadata, a read-me file, and the codebook, but not the minimal dataset to reproduce the results of the corresponding manuscript. The dataset is secured at the Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.<br>Accumulating evidence shows that NAFLD might play a role in the etiology and progression of CVD, but little is known on the association of NAFLD and CVD mortality in patients with a history of a myocardial infarction (MI). Therefore, we studied the relationship of Fatty Liver Index (FLI), as indicator for non-alcoholic fatty liver disease (NAFLD), with 12-year risk of cardiovascular disease (CVD) and all-cause mortality in post-MI patients. We included 4165 Dutch patients from the Alpha Omega Cohort aged 60-80 years who had an MI ≤10 years prior to study enrolment. NAFLD was defined as FLI ≥60. Patients were followed for cause-specific mortality from enrolment (2002-2006) through December 2018. Hazard ratios for CVD and all-cause mortality were obtained by multivariable Cox regression using FLI &lt;30 (indicating absence of NAFLD) as the reference. Baseline FLI as a continuous measure were studied with mortality using restricted cubic splines analyses. The median (IQR) FLI was 68 (48-84). Sixty percent of the patients had FLI ≥60, who were more likely to be male and more often had diabetes, high blood pressure and high serum cholesterol levels. During 12 years of follow-up, 2042 deaths occurred of which 846 from CVD. Patients with NAFLD were at increased risk of CVD mortality (HR: 1.55 [1.19, 2.03]) and all-cause mortality (HR: 1.21 [1.03; 1.41]) compared to patients without NAFLD. Results remained consistent after excluding patients with obesity and diabetes. To conclude, the adverse association of FLI with CVD mortality were stronger in female than in male patients with conventional cut-off points. FLI ≥60, indicating NAFLD, was a predictor for CVD and all-cause mortality in post-MI patients, independent of other cardiometabolic risk factors. However, cut-off points might differ between male and female patients for predicting CVD mortality.

本仓库所包含的数据为元数据、自述文件与代码簿，未包含用于复现对应论文结果的最小数据集。该数据集由荷兰瓦赫宁根大学及研究中心人类营养与健康分部保管。<br>越来越多的研究证据表明，非酒精性脂肪性肝病（non-alcoholic fatty liver disease, NAFLD）可能在心血管疾病（cardiovascular disease, CVD）的病因发生与疾病进展中发挥作用，但目前针对有心肌梗死（myocardial infarction, MI）病史患者的NAFLD与CVD死亡率之间的关联仍鲜有研究。为此，本研究探讨了作为NAFLD指标的脂肪变性指数（Fatty Liver Index, FLI）与心肌梗死后患者12年CVD发病风险及全因死亡率的关联。本研究纳入了来自Alpha Omega队列的4165名荷兰患者，年龄区间为60至80岁，且在研究入组前10年内曾发生MI。本研究将FLI≥60定义为NAFLD。研究对象自2002至2006年入组起，随访至2018年12月，记录其死因特异性死亡率。以FLI<30（提示无NAFLD）作为参照组，通过多变量Cox回归分析获得CVD及全因死亡率的风险比（hazard ratio, HR）。本研究采用限制性立方样条分析，探讨作为连续变量的基线FLI与死亡率之间的关联。本研究中FLI的中位数（四分位距，interquartile range, IQR）为68（48~84）。60%的患者FLI≥60，这类患者更有可能为男性，且合并糖尿病、高血压及血清胆固醇水平升高的比例更高。在12年的随访期间，共发生2042例死亡，其中846例死于CVD。与无NAFLD的患者相比，合并NAFLD的患者CVD死亡率（HR: 1.55 [1.19, 2.03]）及全因死亡率（HR: 1.21 [1.03, 1.41]）均显著升高。在排除合并肥胖及糖尿病的患者后，上述结果仍保持一致。综上，当采用常规临界值时，FLI与CVD死亡率之间的负向关联在女性患者中强于男性患者。FLI≥60（提示存在NAFLD）可作为心肌梗死后患者CVD及全因死亡率的独立预测因子，不受其他心脏代谢危险因素的影响。不过，用于预测CVD死亡率的临界值可能存在性别差异。