MAFLD、hs-CRP升高及二者联合与心血管疾病发病风险的关系:基于开滦队列研究OA

Objective To analyze the relationships between metabolic associated fatty liver disease(MAFLD),elevated hs-CRP,their combination and cardiovascular disease(CVD)risk based on the Kailuan cohort study.Methods A total of 115 248 participants receiving physical examinations from 11 hospitals(including Kailuan General Hospital Affiliated to North China University of Science and Technology)in 2006 and 2008 were included based on the Kailuan cohort study.The clinical data of participants were collected,and incidence of CVD of participants were recorded.Participants were divided into the MAFLD-hs-CRP-group(n=65 886),the MAFLD+hs-CRP-group(n=25 947),the MAFLD-hs-CRP+group(n=14 243)and the MAFLD+hs-CRP+group(n=9 172)according to the occurrence of MAFLD and hs-CRP level.Cumulative incidence of CVD was compared in the four groups.Multivariate Cox proportional hazards regression analysis was used to analyze the relationships between MAFLD,elevated hs-CRP,their combination and CVD risk.Results There were significant differences in age,proportion of male participants,BMI,systolic blood pressure,diastolic blood pressure,alcohol drinking rate,smoking rate,proportion of participants with regular physical exercise,proportion of participants with high school education or above,incidence of hypertension,incidence of hyperlipemia,incidence of diabetes mellitus,fasting blood glucose,TG,TC,LDL-C,HDL-C,ALT,and incidence of CVD in the four groups(P<0.05).Cumulative incidence of CVD in the MAFLD+hs-CRP+group was higher than that in the MAFLD-hs-CRP-group and the MAFLD-hs-CRP+group(P<0.05).There was no significant difference in cumulative incidence of CVD between the MAFLD+hs-CRP+group and the MAFLD+hs-CRP-group(P>0.05).Multivariate Cox proportional hazards regression analysis results showed that after adjusting for all confounding factors,the CVD risk of participants with MAFLD+hs-CRP-,MAFLD-hs-CRP+and MAFLD+hs-CRP+was 1.15 times[95%CI(1.10-1.20)],1.18 times[95%CI(1.12-1.25)]and 1.31 times[95%CI(1.24-1.39)]higher than that of participants with MAFLD-hs-CRP-,respectively.Conclusion MAFLD or elevated hs-CRP can increase CVD risk,and their coexistence can significantly increase CVD risk.